Aim: The present study was undertaken to study the arterial pattern of the coronary arteries and their branches in cadavers which helps in understanding the coronary artery diseases. Materials and methods: A total of 60 formalin fixed adult heart specimens were collected from the Department of Anatomy, irrespective of age, sex, socio-economic status, religion and education status. Visceral pericardium was stripped and subepicardial fat was removed to study the coronary artery and its branching pattern. The branches were dissected manually and carefully till their termination. The coronary artery which gives the PIV artery and determines the coronary preponderance was examined in detail. Results: It was observed that in hearts where the RCA and circumflex artery terminated at the crux, the PIV artery took a L-shaped turn and continued along the posterior interventricular sulcus. If the main artery crossed the crux then the PIV artery was found to arise as a side branch. PIV artery took its origin from RCA in 34(56.67%) hearts and called right preponderance. In 15 (25%) hearts PIV artery originated from circumflex artery, a branch of LCA and called left preponderance. PIV artery arose from both RCA and circumflex artery in 11 (18.33%) hearts. These were called balanced. Conclusion: Arterial pattern and its variations are important to prevent false interpretation of the arterial angiograms in management of coronary artery diseases. K