The inferior epigastric artery is a branch of the external iliac artery on each side. It arises superior to the inguinal ligament and passes superomedially in the layer superior to the peritoneum but deep to the transversalis fascia. Medially, it passes deep to the conjoint tendon. At the level of the arcuate line, it passes superiorly and superficially to perforate the posterior leaflet of the rectus sheath.
Within the rectus sheath, the inferior epigastric artery passes superiorly and ramifies to anastomose with the superior epigastric artery. It lies within the neurovascular plane of the transversalis fascia and transversus abdominis aponeurosis.
At its origin, the artery is important as a landmark for determining the site of the deep inguinal ring. Its pulsation can be felt slightly medial to the deep ring.