The lower trunk of the brachial plexus lies on the upper surface.

The scalene tubercle provides the insertion for the tendon of scalenus anterior.

The stellate ganglion does lie anterior to the neck of the first rib.

The subclavian artery runs in a separate groove behind the scalene tubercle.

The upper surface of the first rib (in front of the scalene tubercle) bears a groove for the subclavian vein.