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The scalene muscles are deep and positioned laterally in the neck (see Image. Neck Muscles). Innervation involves both the brachial plexus and the cervical plexus, contributing to a complex functional role. These multiarticular muscles facilitate accessory breathing and contribute to neck and head movement, as well as postural stability between the neck and head. Dysfunction can lead to pathological conditions such as thoracic outlet syndrome (TOS), reduced ventilatory capacity, and cervical pain. Medical interventions often aim to decrease excessive muscle tone, while rehabilitation focuses on restoring physiological length or enhancing contractile strength. These muscles likewise have significant surgical importance. The anterior scalene serves as a key landmark for identifying the subclavian artery, the brachial plexus, and the phrenic nerve, which courses along its anterior surface. Partial or complete anterior scalene resection may be performed to relieve neurovascular compression during TOS decompression surgery. Additionally, the scalene muscles are relevant in central venous catheterization via the subclavian approach, as their proximity to major vessels increases the risk of vascular or nerve injury. Understanding the anatomy, function, and clinical significance of the scalene muscles helps clinicians manage various conditions in the cervicothoracic area.