Posterior Tibial Artery

Course

The posterior tibial artery begins at the distal border of the popliteus muscle in the posterior leg. Its origin can be described in one of two ways:

• Arising as a branch of the tibioperoneal trunk at the same time as the fibular artery, or 
• Arising as a direct branch of the popliteal artery and then giving rise to the fibular artery.

It then descends along the medial aspect of the posterior compartment of the leg, between the flexor digitorum longus and tibialis posterior. The soleus and gastrocnemius muscles lie superficial to the artery.

As the artery passes between the medial malleolus and calcaneal tubercle, it bifurcates into the medial and lateral plantar arteries, which supply the plantar aspect of the foot.

By TeachMeSeries Ltd (2025)

Fig 1
Arterial supply to the anterior and posterior leg is via the popliteal artery and its branches.

By Y. Yang, M. L. Du, Y. S. Fu, W. Liu, Q. Xu, X. Chen, Y. J. Hao, Z. Liu & M. J. Gao, [CC BY 4.0], via Wikimedia Commons

Fig 2
The posterior tibial artery (4) travels posteriorly to the medial malleolus at the ankle joint.

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Supply

The posterior tibial artery supplies the posterior compartment of the leg and plantar aspect of the foot through the following branches:

• Circumflex fibular artery – passes around the fibular neck and through the soleus to supply the proximal fibula and proximal tibiofibular joint.
• Nutrient artery of the tibia – supplies the tibia distal to the soleal line.
• Muscular branches – supply the muscles within the posterior compartment of the leg.
• Perforating branches – supply the periosteum and overlying skin.
• Communicating branch – anastomoses with the communicating branch from the peroneal artery.
• Medial malleolar branches – supply the skin via the medial malleolar network.
• Calcaneal branches – supply the heel area and medial plantar muscles of the foot.
• Medial plantar artery – travels distally to the medial border of the hallux to join with a branch of the first plantar metatarsal artery.
• Lateral plantar artery – descends distally to the reach the lateral aspect of the fifth metatarsal before travelling medially to reach the space between the first and second metatarsal bases. Here it joins the deep plantar artery to form the plantar arch.