The median sacral artery (or middle sacral artery) is a small vessel, which arises posterior to the abdominal aorta,superior to its bifurcation.
It descends in the middle line in front of the fourth and fifth lumbar vertebræ, the sacrum and coccyx, and ends in the glomus coccygeum (coccygeal gland).
From it, minute branches are said to pass to the posterior surface of the rectum.
On the last lumbar vertebra it anastomoses with the lumbar branch of the iliolumbar artery; in front of the sacrum it anastomoses with the lateral sacral arteries, and sends offsets into the anterior sacral foramina.
It is crossed by the left common iliac vein, and is accompanied by a pair of venæ comitantes; these unite to form a single vessel, which opens into the left common iliac vein.