Four cases of cervical aortic arch are described and correlated with the 21 previously reproted cases. Five distinct forms of cervical aortic arch were found and classified according to configuration of the aorta, sequence of brachiocephalic branching, and embryogenesis. In brief, Type A has separate external and internal carotid artery branches from the aortic arch. Tye B is similar but has dual common carotid arteries. Type C is a left cervical arch with a right-sided descending aorta and bicarotid trunk. Type D is a left cervical arch with a normal branching pattern, redundant transverse aorta and left-sided (often hypoplastic) descending aorta. Type E is a right cervical aortic arch with a right descending aorta and an aberrant left subclavian artery.