The descending genicular artery is found in the anterior (front) portion of the thigh. It branches off from the femoral artery and then immediately splits into the saphenous branch and the articular branches of the descending genicular artery.

The main portion of the descending genicular artery, also known as the supreme genicular artery, supplies blood to the knee joint before branching. The saphenous branch of the descending genicular artery supplies blood to the skin on the upper and medial surfaces of the leg. The saphenous nerve travels alongside this artery as it passes between the sartorius and gracilis muscles. The articular branches of the descending genicular artery join with two other blood vessels, the medial superior genicular artery and anterior recurrent tibial artery on the side of the knee. Together, these three arteries supply blood to the knee joint while also sending off a branch that connects to blood vessels of the leg.

The descending genicular artery rarely has an aneurysm, which is a ballooning of weak blood vessel walls. In some cases, this artery is used as a bypass route when other blood vessels of the leg develop blood clots or other blockages.