With the increasing use of free tissue grafts for extensive reconstruction of the head and neck, it is important to document and understand the types of vascular variations. We report an unusual arrangement of numerous interconnecting tributaries to the medial temporal vein (MTV) in a 73-year-old male cadaver. Another unusual feature was the division of the MTV into three parallel segments, which reunited into a single stem. The presence of an extensive venous plexus in the temporal region may be hazardous for surgical operations. Surgeons performing vascular or reconstructive surgery should be aware of this unexpected variation of temporal region venous drainage in the hope of preventing inadvertent injury.