The median sacral artery (or middle sacral artery, Latin: arteria sacralis mediana) is a small posterior branch of the abdominal aorta that originates superior to its bifurcation.
It arises posterior to the abdominal aorta and just above the bifurcation, then travels downward. First, the median sacral artery passes over the anterior surfaces of the lower lumbar vertebrae and then along the anterior surface of the sacrum and coccyx.
On its course, it is accompanied by a pair of committing veins and crossed by the left common iliac vein.
The median sacral artery provides small branches to the posterior surface of the rectum.