Median sacral artery (also known as middle sacral artery) is a small artery that arises from the bifurcation of aorta at the level of fourth lumbar vertebra. It may also arise from the back of the aorta little above its bifurcation. It descends in the midline in front of the fourth and fifth lumbar vertebrae, the sacrum and the coccyx. It eventually ends in the coccygeal gland.
Median sacral artery gives minute branches to the posterior surface of the rectum. It also forms anastomoses with the lumbar branch of the iliolumbar artery in front of last lumbar vertebra and lateral sacral arteries in front of the sacrum.