Background: Cervical Sympathetic Trunk (CST) differs from other parts of the sympathetic chain in having only three ganglia corresponding to eight cervical spinal segments and the absence of white rami communicantes1. Awareness of the variations of CST helps the surgeon to identify and preserve it during surgical interventions of the neck, thus reducing CST injury. The purpose of present study is to introduce the incidence of vertebral ganglion other than the normal once. Materials & Methods: In this cross-sectional study, 50 cervical sympathetic trunks (chains) were studied by bilateral neck dissections of 25 formalin fixed adult human cadavers from the Department of Anatomy, Government Medical College Thrissur. Results: Superior cervical ganglion (SCG) was consistently seen in all sympathetic chains. Middle cervical ganglion (MCG) was present in 27 (54%) chains studied; Inferior cervical ganglion (ICG) was present in 38 (76%) CSTs. In case of stellate ganglion (SG), it was present in 12 (24%) chains. vertebral ganglion (VG) was present in 33 (66%) chains. Middle and vertebral ganglia co-existed in 10 cases. The most common type of CST consisted of SCG, VG and ICG (17, 34%). Conclusions: This study concludes that, in addition to the above-mentioned ganglia, VG was present in 33 specimens. Our study also emphasizes the need for awareness of the presence of vertebral ganglion in CST which is needed during cervical surgical procedures to prevent inadvertent injury to it.