Simple SummaryThe weight of an adult African elephant can be over six tons, and even the smaller Asian elephant can weigh over four tons. Their limbs support the body nonstop because elephants rarely lay down as standing up is a difficult and lengthy process. Consequently, even a small injury to the sole, the digits, or the digital cushion can result in a serious abscess or ulcer on the foot, eventually leading to the death of the animal. Surgical solutions are limited due to the lack of anatomical descriptions of the region’s blood supply. The aim of this study was to provide anatomical guidance for the blood supply of the foot. We created a detailed 3D model of both the skeletal and the arterial structures, explaining the blood supply of the digits, the sole, and the digital cushion. This information may be used in the preservation of this endangered species through a better understanding of foot diseases and planning surgeries in clinically affected animals.AbstractBeing the largest still-living terrestrial mammal on earth, an elephant’s feet play an important role in its health status. The musculoskeletal structures in the forefoot are well described in the literature, but information about vascularization is limited. The novel aim of this work is to provide anatomical guidance to structures found in the forefoot, focusing on the arterial system. Initially, native CT and MRI sequences were taken of the left forefoot of a deceased 6-year-old female Asian elephant; the foot was then filled with an iodine-containing contrast medium through the a. mediana and the CT scans were repeated in the same position. The images obtained were processed with 3D Slicer software for the 3D reconstruction of the bones and arteries. The results clearly showed the palmar blood supply of the forefoot. A so far undescribed vessel was revealed, stemming from the a. metacarpea, supplying the first digit and the digital cushion. The course of the deep palmar arch’s terminal section was also established. This paper provides the first description of the exact disposition of the arteries in the palmar aspect of an elephant’s forefoot and may be used in planning surgeries in clinically affected animals.