The sciatic nerve (SN) is the largest nerve in the human body. It is made-up of ventral rami from lumbar to sacral spinal nerves and ultimately bifurcates into the common fibular (peroneal) nerve (CFN) and the tibial nerve (TN), most frequently just proximal to the popliteal fossa. Together, these nerves provide motor innervation to the lower leg muscles as well as the majority of sensory innervation to the skin of the lower leg. Sciatica is the term used to describe pain caused by compression of the SN, and it classically presents nerve pain, numbness, tingling, and weakness in the affected extremities. This case report details a 92-year-old white female donor who was found to have a bilateral high bifurcation of her SNs that passed between two heads of the piriformis muscle (PM). Identification of this anatomical variation inspired the initiation of a longitudinal research project at the Uniformed Services University of the Health Sciences (USUHS), during which we will analyze 70 cadavers with the objective of describing and quantifying the prevalence of high bifurcation of the SN variations and the involvement of the PM. This and other similar variations of the SN bifurcations have clinical implications, including diagnosis and treatment of sciatica pain, popliteal nerve block administrations, and surgical planning, all of which will be discussed here.