The brachial artery usually bifurcates into its terminal branches, the radial and ulnar arteries, slightly distal to the elbow joint. However, it is not uncommon for this bifurcation to occur proximally. The reported prevalence of HBBA is 12.3%.[2] HBBA is associated with a higher incidence of the failure of arteriovenous fistula creation.[3] The functional patency rate of arteriovenous fistulae at 12 months created in patients with HBBA is less (53.4%) than the normal brachial artery (74.5%).[3] Moreover, the superficial radial artery, which is associated with the HBBA, may pose a high risk for iatrogenic cannulation injuries, particularly in patients undergoing hemodialysis.[4] Even though the vascular mapping is recommended before the arteriovenous fistula creation, it is not uncommon to perform this procedure based on anatomical landmarks,[5] particularly in resource‑poor settings. Thus, we intended to assess the prevalence of HBBA in Sri Lanka