The objective of this article is to review topography of posterior superior alveolar artery (PSAA), and to present a case with visualization of a rare anatomic variation of PSAA. An electronic search was undertaken to identify articles about topography of PSAA in Medline, Embase, and Google Scholar databases, published between January 1977 and December 2017. Two animal studies, 8 cadaver studies, 18 cone-beam computerized tomography (CBCT) studies, and 2 review articles were found. The animal studies, cadaver studies, and review articles were excluded because they were not about topography of PSAA. Only CBCT studies were included in this review. Accurate knowledge of vital structures in the surgical area is critical during surgical procedures. PSAA should be analyzed during planning sinus lifting with lateral approach. In the present case, a detailed evaluation of patient by CBCT provided the opportunity to find out a rare variation of PSAA with multiple vessels.