Vascular anatomical variants of the hepatic artery are common and can significantly influence surgical planning for pancreatic and liver procedures, particularly in minimally invasive pancreaticoduodenectomy (MIPD). The standard hepatic arterial anatomy includes the common hepatic artery arising from the celiac trunk, which bifurcates into the proper hepatic artery (PHA) and then into the right (RHA) and left hepatic arteries (LHA). However, variations such as replaced or accessory hepatic arteries (AHA) and trifurcations are present in a significant proportion of patients. These variations, often arising from the superior mesenteric artery (SMA) or aorta, can complicate MIPD by increasing the risk of vascular injury during surgery, leading to complications like ischemia or bleeding. Preoperative imaging, especially contrast-enhanced CT and angiography, is crucial for identifying these variants, as they influence the surgical approach and help avoid intraoperative injuries. The decision to ligate or preserve an aberrant RHA depends on factors like the tumor’s proximity to the artery and the size of the aberrant vessel. The presence of an experienced minimally invasive surgeon and careful patient selection are key to successful outcomes. In cases requiring arterial reconstruction, particularly when dealing with a large rRHA, laparotomic conversion may be necessary for safe anastomosis. Ultimately, the tumor’s relationship with the arterial anomaly is the primary factor guiding surgical management.