The persistent hypoglossal artery[PHA] is a rare anomaly that belongs to the group of embryonic carotid-basilar artery anastomoses that may occur in adults. The most commonly reported type of such an anastomosis is the primitive trigeminal artery, followed by the PHA. We report a 35-year old man, hospitalized because of an intraventricular hemorrhage, who was found to have a right persistent PHA. Three-dimensional computed tomography[CT] angiography provided excellent anatomical topology of the anomaly. To our knowledge, this patient is the first case of a PHA identified by this means in Korea.