The lateral sacral arteries typically originate from the posterior trunk of the internal iliac artery (Read more!) as a single trunk that divides into the superior and inferior branches. However, they can also arise as two separate arteries.

These arteries can range from one up to four lateral sacral arteries on one side. Rarely, they are absent. In addition, the lateral sacral arteries may also arise from the anterior trunk of the internal iliac artery, sciatic artery, superior gluteal artery, and inferior gluteal artery instead of the posterior trunk of the internal iliac artery.

The superior lateral sacral artery is usually larger than the inferior counterpart. It passes dorsally and medially toward the pelvic surface of the sacrum. It forms an anastomosis with the middle sacral artery and gives off the spinal branches that enter the sacral canal via the first and/or the second anterior sacral foramina. This artery supplies the contents of the sacral canal and the skin and muscles over the dorsal aspect of the sacral region as it leaves the sacral canal via the first and/or second posterior sacral foramina.
The inferior lateral sacral artery passes obliquely over the pelvic surface of the sacrum and the sacral roots of the sciatic nerve. It also travels lateral to the sacral part of the sympathetic trunk. Like the superior lateral sacral artery, this artery also gives rise to the spinal branches that pass through the anterior sacral foramina to supply the contents of the sacral canal and the skin and muscles of the dorsal sacral region. This artery usually also forms anastomosis with the middle sacral artery, and it can anastomose with the inferior lateral sacral artery of the opposite side.

Overall, the lateral sacral arteries supply the multifidus and erector spinae muscles, sacral vertebrae, coccyx, spinal meninges, spinal cord, and other contents of the sacral canal, as well as the skin over the posterior sacral region.

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Lateral sacral arteries