The left anterior descending artery (LAD), also known as the anterior interventricular artery, is the largest of both branches of the LCA. It travels within the anterior interventricular sulcus obliquely down the sternocostal surface of the heart.

It may terminate at the apex of the heart, but it usually curves around the inferior margin of the heart, reaching the diaphragmatic surface. Here it passes in the posterior interventricular sulcus and anastomoses with the posterior descending artery (PDA).

The left anterior descending artery (LAD) gives rise to several branches, including the following:

Septal perforating branches - they are also known as the interventricular arteries; they pierce the interventricular septum and supply its anterior two-thirds;
Diagonal branches - pass over the anterior surface of the left ventricle and supply it.

Also, the LAD usually gives off a small left conus (pre-infundibular) artery. It arises from the proximal aspect of the artery and supplies the outflow tract of the right ventricle. It forms an anastomosis with the same-named artery of the right coronary artery (RCA).

Moreover, the LAD gives off several small right ventricular branches that supply a small portion of the anterior aspect of the right ventricle and anastomose with the anterior right ventricular branches of the RCA.

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Left anterior descending artery (LAD)