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An anomalous common trunk giving rise to bilateral intercostal arteries at multiple levels is exceedingly rare and its association with spinal filar AVF and low-lying cord has not been reported so far. Here, we report this uncommon anatomical variation in a 60-year-old male who presented with paraplegia and on imaging found to have low-lying spinal cord with filar AVF and venous congestive myelopathy and discuss its embryological basis and associated malformations. Although rare, interventional radiologists should be aware of this entity, as these trunks may be a major source of bleeding in patients with hemoptysis, and also may be involved in vital spinal cord supply.