Intrahepatic vascular variation, a consequence of congenital developmental abnormalities, encompasses a spectrum of anatomical deviations in hepatic arteries, portal veins, and hepatic veins. While these variations often remain clinically silent, they hold significant implications for liver surgeries, transplantations, and interventional procedures. This chapter provides a comprehensive exploration of the types, prevalence, and clinical significance of hepatic vascular variations. It delves into Michel’s classification of hepatic artery variations and Covey’s classification of portal venous systems, offering insights into the diverse anatomical arrangements encountered in clinical practice. The chapter emphasizes the critical importance of preoperative evaluation, highlighting the shift from invasive angiography to non-invasive imaging techniques, such as multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI). These advanced imaging modalities have revolutionized the assessment of vascular anatomy, providing detailed, three-dimensional visualizations crucial for surgical planning and risk assessment. The chapter also examines various imaging manifestations of vascular variations across different modalities, including traditional angiography, CT angiography, and MRI vascular imaging. A case study is presented to illustrate the practical implications of identifying these variations during interventional procedures, underscoring the real-world relevance of this knowledge. The chapter concludes by emphasizing the paramount importance of understanding and accurately assessing intrahepatic vascular variations for successful liver surgeries and interventions. This knowledge is indispensable for radiologists and surgeons, serving as a cornerstone for optimizing patient outcomes in hepatobiliary procedures and minimizing the risk of complications related to unexpected vascular anatomy.