Cervical ribs constitute the most important variants among ribs, particularly because of their proximity to the brachial plexus nerve network and subclavian artery. Thus, cervical ribs may exert excessive pressure upon these structures, producing a variety of symptoms that may be considered as a neuro-vascular complex. Cervical ribs are not uncommon in the catalogue of anatomic abnormalities in modern medicine, but few cases have been reported from historic skeletal material. We conducted a review with the existent articles published in palaeopathological literature, the historical background with the most important milestones regarding the studies on cervical ribs, the embryological processes in their development, and their prevalence and principal clinical features. Finally, we described a case of a cervical rib that was observed in the skeletal remains of a young individual from the late medieval cemetery of Corfinio (12th-13th century CE, Italy).