Posterior tibial artery: course through the calf to behind the medial malleolus

Where does the posterior tibial artery run?

Just below the knee the popliteal artery divides into a front and a back branch. The front one is the anterior tibial artery; the one that stays behind is the posterior tibial artery, the main supply of the calf and sole.

The view above shows the right leg from behind. The yellow posterior tibial artery continues from the popliteal artery straight down through the calf toward the inner ankle. It is the larger of the two branches, and the level of division varies.

Deep in the calf

The calf muscles form a superficial layer, the gastrocnemius and soleus (together the triceps surae), and a deep layer, including tibialis posterior, flexor digitorum longus and flexor hallucis longus. The artery runs between the layers with the tibial nerve. Soon after its origin it gives off the fibular artery, which runs down along the fibula; some textbooks treat the fibular artery as a third branch of the popliteal.

Behind the medial malleolus to the sole

At the ankle it curves behind the medial malleolus, close to the surface, through the tarsal tunnel under the flexor retinaculum. From front to back the structures there are the tendons of tibialis posterior and flexor digitorum longus, the posterior tibial artery and veins, the tibial nerve, and the tendon of flexor hallucis longus. In the sole it divides into the medial and lateral plantar arteries.

Name and terms

Tibial means of the tibia. Related terms: fibular (peroneal) artery, tarsal tunnel, plantar arteries. The Latin is arteria tibialis posterior.

See it in the app

Hidden deep in the calf, the posterior tibial artery barely shows in muscle drawings. In the 3D anatomy app teamLabBody you can keep only the bones and vessels, rotate to the back and follow it from behind the knee to behind the medial malleolus; add the anterior tibial artery to see where the two divide. Cross sections are available with the PREMIUM plan.

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