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The sympathetic chain is a ganglionated chain present bilaterally extending from the base of the skull to the coccyx. It divides into cervical, thoracic, lumbar and sacral segments. The two side chains fuse at the ganglion in front of the sacrococcygeal junction. In this article, the lumbar sympathetic chain is discussed in detail below. Location and relations: It presents four interconnected ganglia, on either side. Lumbar sympathetic chain lies anterolateral to the bodies of lumbar vertebrae, deep to the medial aspect of the psoas major muscle. Superiorly it is continuous with the thoracic sympathetic chain passing behind the medial arcuate ligament of a diaphragm Inferiorly it passes behind the common iliac vessels over the sacral ala and continuous with the sacral sympathetic chain On the right side, it lies posterior to inferior vena cava On the left, it lies postero-lateral to the aortic lymph nodes