The nerve to mylohyoid muscle supplies the mylohyoid and the anterior belly of the digastric muscles, with terminal sensory branches that might innervate the submental skin and mandibular teeth. The nerve to mylohyoid muscle typically originates from the posterior surface of the inferior alveolar nerve right before entering the mandibular foramen. In rare cases, the nerve to mylohyoid muscle arises from the lingual nerve. The variations of the nerve to mylohyoid muscle might have led to failure of an inferior alveolar nerve blockade. During the routine dissec-tion of a cadaveric head, a rare case was identified where the nerve to mylohyoid muscle had origins from both the inferior alveolar and lingual nerves. This case is reviewed and salient literature reviewed.