The aim of the study was to determine the distribution patterns of multiple renal arteries, evaluate how they are affected by gender and bilateral asymmetry and proceed on a systematic review. Two hundred and six kidneys from 103 Greek cadavers (53 males and 50 females) were investigated. The number and pattern of multiple renal arteries were determined according to side, gender and level of origin. The distances between the main renal and first multiple renal arteries were also measured. Multiple renal arteries were present in 11.2% of the kidneys. No statistically significant difference was found between side and gender (p>0.05). The incidence of multiple renal arteries was 87% unilaterally and 13% bilaterally. As regards the multiple renal arteries, a single artery was detected in 83%, two in 13% and three in 4.3%. In 30.4% (7/23) of the kidneys, there was a short common trunk (<1.5 cm), early dividing into the main renal artery and a thinner artery. Multiple renal arteries on the left side seemed to emerge lower than the right ones and displayed a greater variability at their origin. In the systematic review, we detected the patterns of multiple renal arteries which were classified according to population, gender, side and specimen (cadaveric, radiological or transplant). The awareness of morphology and topography of the multiple renal arteries is important in order to achieve a safe pre and intraoperative management of the renal vascular supply.