Popliteal Artery: Anatomy, Course, Branches and Clinical Relevance

Last Updated on August 18, 2025

The popliteal artery is the direct continuation of the femoral artery as it passes through the adductor hiatus in the adductor magnus muscle, at the junction of the middle and lower thirds of the thigh. It is the principal arterial supply to the knee, leg, and foot. In the popliteal fossa, it lies deep and central, closely related to the posterior capsule of the knee joint, and is the deepest of the neurovascular structures in this region.

The artery terminates at the lower border of the popliteus muscle, where it divides into its terminal branches:

• Anterior tibial artery
• Posterior tibial artery, usually via a short tibioperoneal trunk that also gives rise to the peroneal artery

Through its multiple genicular branches, the popliteal artery participates in the periarticular genicular anastomosis, ensuring collateral circulation around the knee.

Course of Popliteal Artery

The femoral artery, a continuation of the external iliac artery, is the main artery of the lower limb. er limb. In the thigh, it travels through the adductor canal and comes out of the adductor canal through the adductor hiatus ( an opening in the adductor magnus, at the junction of the middle and lower thirds of the thigh).

After coming out through adductor hiatus, the artery enters the popliteal fossa, initially positioned medial to the femur, then angling slightly laterally as it descends towards the intercondylar fossa. Throughout its course, it lies deep to the popliteal vein and tibial nerve, and in close relation to the posterior capsule of the knee joint.

Popliteal arterey is anterior to the bone in the femoral canal, and as it travels below becomes anteromedial first and then medial at the adductor hiatus and then travels posterior to the bone.

 In the upper part of the popliteal fossa, the artery lies against:

• The popliteal surface of the femur, separated by a layer of fat
• The posterior aspect of the knee joint capsule

In its course, it gives off branches some of which participate in the formation of the periarticular genicular anastomosis.

In the lower part of its course, it is situated between the gastrocnemius and popliteus muscles, traveling vertically downward to the lower border of the popliteus. Here, it divides into:

• Anterior tibial artery, passing through the interosseous membrane to the anterior compartment
• Posterior tibial artery, continuing in the posterior compartment, often preceded by a tibioperoneal trunk that also gives rise to the peroneal artery

The popliteal artery is the deepest or anteriormost structure in the popliteal fossa and the artery runs in close proximity to the joint capsule of the knee as it spans the intercondylar fossa.

Anatomic Relations of Popliteal Artery

Branches of Popliteal Artery

Terminal Branches

• Anterior tibial artery: Passes forward through the interosseous membrane to the anterior compartment of the leg
• Posterior tibial artery: Continues in the posterior compartment, often via a tibioperoneal trunk that also gives rise to the peroneal artery

Collateral Branches

Muscular Branches

• Superior muscular branches: Two or three branches to the lower adductor magnus and hamstrings. These anastomose with the terminal profunda femoris branches
• Sural arteries (inferior muscular branches): Also called inferior muscular arteries, these are two large branches that arise opposite the knee joint and supply the gastrocnemius, soleus, and plantaris.

Cutaneous Branches

• The cutaneous branches arise either from the popliteal artery or from some of its branches. These descend between the gastrocnemius heads and supply the posterior leg skin
• One branch often accompanies the small saphenous vein

Genicular Arteries

• Superior genicular arteries (medial and lateral): Wind above the femoral condyles to the front of the knee joint. The medial branch may supply the vastus medialis
• Middle genicular artery: It is a small branch, arises opposite the back of the knee joint. It pierces the oblique popliteal ligament to supply the intra-articular ligaments and synovium
• Inferior genicular arteries (medial and lateral): Arise below the gastrocnemius to supply knee joint and adjacent soft tissues

Genicular arteries, apart from supplying structures around the knee, create anastomoses around the knee.

The genicular branches form a periarticular network with contributions from femoral and tibial vessels.

This network maintains collateral flow during knee flexion or proximal arterial obstruction.

Variations of Popliteal Artery

• High bifurcation – Division into terminal branches above the level of the popliteus, with the anterior tibial artery passing deep to it
• Anterior tibial and peroneal divisions – Posterior tibial artery absent or rudimentary
• Trifurcation – Division into anterior tibial, posterior tibial, and peroneal arteries at the lower popliteal fossa (true trifurcation rare)
• Aberrant course – Rare anomalous relations to the popliteus or joint capsule, potentially predisposing to entrapment

Clinical significance of Popliteal

Artery Pulse Palpation

• Best palpated with the knee slightly flexed
• Absence or diminution suggests proximal obstruction.
• Comparison with distal pulses helps localize the disease

Popliteal Artery Aneurysm

• Most common peripheral artery aneurysm
• Presents with pulsatile swelling, distal embolization, or compressive symptoms on tibial nerve or popliteal vein
• Managed by surgical or endovascular repair if symptomatic or large

Popliteal Artery Entrapment Syndrome (PAES)

• Popliteal artery entrapment syndrome is compression by abnormal muscular or tendinous structures, often medial head of gastrocnemius
• Common in young athletes with exertional calf pain and reduced distal pulses during active plantarflexion
• Treated by surgical decompression

Trauma

• Susceptible to injury in knee dislocations and periarticular fractures due to fixed position and proximity to joint capsule
• Requires urgent vascular repair to prevent limb ischemia

Ischemia in Knee Flexion

Prolonged extreme flexion may impair arterial flow in susceptible patients

ReferencesSave

• Bowers Z, Nassereddin A, Sinkler MA, et al. Anatomy, Bony Pelvis and Lower Limb: Popliteal Artery. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537125/
• Aragonés P, Rodríguez-Niedenführ M, Quinones S, de Blas CS, Konschake M, Sanudo JR, Vázquez MT. Popliteal artery: Anatomical study and review of the literature. Ann Anat. 2021 Mar;234:151654. [PubMed]
• Tarasiuk A, Tubbs RS, Zielinska N, Karauda P, Gonera B, Olewnik L. Variations of the popliteal artery: A review. Ann Anat. 2023 Aug;249:152100. [PubMed]
  Save