The inferior epigastric artery is a major artery of the anterior abdominal wall. It is one of two branches of the external iliac artery (Read more!), arising from its medial side just before the artery passes beneath the inguinal ligament (Read more!).

The inferior epigastric artery may also arise from the femoral artery or obturator artery, but it happens rarely. This artery supplies the skin, subcutaneous tissue, and muscles of the anterior abdominal wall, as well as some deeper structures of the abdominal wall.

From its origin, the inferior epigastric artery ascends in an oblique path along the anterior abdominal wall medial to the deep inguinal ring. At this point, the inferior epigastric vessels define the lateral border of Hesselbach's triangle, which is an anatomical landmark that marks the formation site of a direct inguinal hernia. The medial and inferior borders of the triangle are formed by the rectus abdominis muscle and the inguinal ligament, respectively.

At first, the inferior epigastric artery runs anterior to the transversalis fascia. Then, it pierces the fascia below the arcuate line, entering the rectus sheath. It continues to ascend, going posterior to the rectus abdominis muscle. It terminates at the level of the umbilicus by dividing into several branches and anastomosing with the superior epigastric artery.

As it travels above the arcuate line, the inferior epigastric artery creates visible elevation on the parietal peritoneum, forming the lateral umbilical fold. At the level of the umbilicus, it also gives rise to several muscular branches.

Each inferior epigastric artery is accompanied by an inferior epigastric vein. Along its course, the inferior epigastric artery gives rise to several side branches, including the following:

Artery of round ligament of uterus - runs within the inguinal canal alongside the round ligament of the uterus; supplies the round ligament and adjacent tissues; it is the female counterpart of the cremasteric artery in males;
Pubic branch - arises near the femoral ring and goes behind the pubic bone toward the obturator foramen; supplies the pubic bone and pubic symphysis;
- Accessory obturator artery - connects the pubic branch of the inferior epigastric artery with the pubic branch of the obturator artery, forming the corona mortis; provides additional supply to the area typically supplied by the obturator artery; it may also be referred to as the obturator branch of the pubic branch; it is not always present.

In addition to its named branches, the inferior epigastric artery also gives off several unnamed muscular and cutaneous branches that vary in course and number. They supply the parietal peritoneum, aponeuroses, muscles (including the rectus abdominis, transversus abdominis, and internal abdominal oblique), and the subcutaneous tissue and skin of the anterolateral abdominal wall.

The corona mortis (Latin for “crown of death”) refers to a vascular anastomosis between the obturator vessels and either the external iliac or inferior epigastric vessels. This connection can be arterial, venous, or both, and it typically crosses over the superior pubic ramus. Clinically, it is significant because injury to the corona mortis during surgeries can lead to life-threatening hemorrhage, due to its location and potential for being overlooked. Its presence is variable, occurring in approximately 15 - 40% of individuals, and its exact size and path can differ between people.

Note: When the superficial epigastric artery is present, the inferior epigastric artery is often referred to as the deep inferior epigastric artery.

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Inferior epigastric artery