The brachiocephalic veins (BCV) are central veins formed by the internal jugular and subclavian veins, as they return blood from the cranial and upper limb circulations through the thoracic inlet (Fig. 40.1). The right BCV (RBCV) and left BCV (LBCV) join and form the superior vena cava (SVC). The structures bordering the BCV are the thyroid gland, common carotid arteries, trachea, phrenic nerve, and manubrium. BCV complications can arise from neck and reconstructive surgery, central venous catheterization, and congenital heart disease and malformations.