Background of study– A detailed knowledge of variations in the origin and branching pattern  of Thoraco–acromial artery(TAA)  is important during various reconstructive and microvascular surgeries. Materials and methods– Hundred formalin fixed specimens were studied at Government Medical College, Kozhikode, Kerala, India over a period of four years. Results– Normal quadrifurcation pattern was observed in majority of specimens (84%). The division of TAA into two trunks was seen in 9% followed by ramification into multiple branches in 4% specimens. Some specimens showed trifurcation (3%). Conclusion– In this scenario of increasing reconstructive surgeries, a thorough knowledge on the anatomical variations of TAA will be helpful to surgeons as this artery provides vascular supply to Pectoralis Major Myo–Cutaneous flap.