Brachial vein has been overlooked as a conduit for arterial bypass. It can be harvested with very little morbidity. A deep incision placed on the medial aspect of the upper arm allows exposure of the brachial and basilic veins, giving access to vein of adequate length and diameter for many applications. The medical deep veins of the upper arm are usually our first alternative to ipsilateral saphenous vein for autogenous reconstruction. Because of inconsistent anatomy and nomenclature in this area, we refer to these veins as the "deep brachial vein complex".