The lower leg venous system consists of the superficial (greater saphenous vein) and deep (femoral vein) systems. Duplicated saphenous systems exist in the calf and thigh in approximately 25% of patients.

Distally, the greater saphenous vein can be found anterior to the medial malleolus. It crosses the tibia, runs medial to the knee, and ascends into the medial and posterior segment of the thigh as it descends medially into the common femoral vein in the groin (saphenofemoral junction).

In the thigh, the greater saphenous vein lies deep to the fascia (unlike accessory veins or tributaries). This may help discriminate the veins of the thigh during dissection.

In the proximal aspect of the thigh, the greater saphenous vein runs into the confluence of the superficial circumflex iliac vein, superficial inferior epigastric vein, and external pudendal veins to create the saphenofemoral junction. A useful anatomic landmark for the saphenofemoral junction is two fingerbreadths inferior and medial to the pubic tubercle.