 This is a review article on the arterial supply of the lower cranial nerves with special emphasis on clinical issues by Philopendrics and colleagues and will be published in January 2014 in the upcoming special issue on the clinical anatomy of the cranial nerves. The lower cranial nerves receive their arterial supply from an intricate network of tributaries derived from the external carotid, internal carotid, and vertebro basilar territories. Understanding of this network is of great relevance for skull-based surgery as iatrogenic injury to regional vessels and thin branches supplying the cranial nerves can result in post-operative cranial nerve deficits even in absence of direct nerve manipulation. The intercranial portion of the trigeminal nerve is supplied by branches of the basilar artery as well as the inferior lateral and meningeal-hypophaceal trunks of the internal carotid artery. The external carotid artery contributes via the middle meningeal and ascending pharyngeal artery. The ophthalmic nerve receives its blood supply from the anterior-medial branch of the inferior lateral trunk and tributaries of the ophthalmic artery. The maxillary and mandibular nerves are irrigated by the interior lateral branch and posterior-medial branch of the inferior lateral trunk respectively as well as the external carotid artery. Trigeminal neuralgia, a condition characterized by sudden brief episodes of electric shock-like facial pain confined to the distribution of one or more branches of the trigeminal nerve has been associated with arterial compression of the trigeminal nerve at the root entry zone. The superior cerebellar and interior inferior cerebellar arteries are the most common offending vessels. The facial nerve receives its blood supply intercranially from the interior inferior cerebellar and labyrinthine artery as well as the patrocial branch of the middle meningeal artery, the styloemastoid artery, and the tympanic arteries. Extracranially, the nerve is supplied by the posterior auricular, occipital, superficial temporal, facial and maxillary arteries. The vestibulococlear nerve is supplied by the interior inferior cerebellar and labyrinthine artery. The latter divides into the common cochlear and interior vestibular artery to supply the labyrinth. Vascular compression of the proximal facial nerve can result in hemifacial spasm, a condition characterized by involuntary unilateral spasm of muscles innervated by the facial nerve. The intracranial glossopharyngeal and vagus nerves are supplied by branches of the vertebrular, basilar and menomaningeal artery as well as the neuromaningeal trunk of the ascending pharyngeal artery. The ascending pharyngeal, occipital, descending palatine, sphenopalatine, ascending palatine, dorsolingual artery, and all external carotid artery branches supply the extra cranial portion of the glossopharyngeal nerve. The extra cranial vagus nerve receives blood supply from the internal, external, and common carotid as well as the posterior meningeal artery, a branch of the vertebral artery. Along its course, the vagal artery, a branch of the inferior thyroid artery, vertebral, internal thoracic, bronchial, esophageal arteries, and the aorta all contribute. The spinal accessory nerve is supplied by the posterior inferior cerebellar artery. The musculospinal and neuromaningeal trunks of the ascending pharyngeal artery and the interior and posterior spinal arteries. The occipital and lingual artery provide the extra cranial blood supply. The intracranial hypoglossal nerve receives its supply from the anterior spinal artery, posterior inferior cerebellar artery, the posterior meningeal artery, and the neuromaningeal trunk. Extracranially, the ascending pharyngeal, occipital, facial, and lingual arteries all contribute. Glossopharyngeal neuralgia, a rare facial pain syndrome characterized by pain affecting the pharynx, tonsillar region, posterior tongue, ear, or angle of the mandible, has been associated with compression of the nerve by either the vertebral or posterior inferior cerebellar artery. Carotid and arteryctomy rarely results in vagus, facial, and hypoglossal nerve deficits from injury to the nerve's vascular supply. Lastly, spasmodic torticollis, it's a condition characterized by uncontrollable chronic and intermittently tonic contractions of the neck muscles leading to abnormal head posture. This disease is associated with vascular compression of the spinal accessory nerve, the upper cervical nerve roots, and the brain stem by the vertebral artery or the posterior inferior cerebellar artery.