Introduction: Atlas is the first cervical vertebra. Foramen tranversarium transmits vertebral vessels and sympathetic plexus. An additional foramen on the transverse process has been named foramen of Arcuale or Arcuate foramen. Aim: To find incidence and clinical correlation of foramen of Arcuale. Methodology: 32 atlas vertebrae from various colleges of Maharashtra were studied in the present study for presence of variant foramen. Results: Foramen of Arcuale was seen bilaterally in 3 atlas vertebrae giving a incidence of 9.37%. There were no other abnormalities in the bones. Conclusion: The course of the vertebral artery may be distorted with this extra foramen. This variation has been a known contraindication for C1 lateral mass screw fixation procedures. Knowledge of this variation will prove helpful for radiologists during CT and MRI and neurosurgeons during cervical surgery.