The Palmaris longus muscle (PL) is considered one of the most variable muscles in the human body. Usually, the anatomical variations of the PL are not symptomatic. Nevertheless, a reversed Palmaris longus (RPL) can cause median nerve and less frequently, ulnar nerve compression. It is usually described in the anatomical literature that the RPL is more often on the left side. Nevertheless, the literature review shows that most of the cases show a right side RPL. In this study we describe an RPL, its relationship to the median nerve, discuss the clinical importance of this finding and review the literature.