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The sphenopalatine artery (SPA) is a well-recognized vessel in otolaryngology and is commonly termed the "artery of epistaxis." Epistaxis is among the most frequent ear, nose, and throat–related emergencies, and approximately 60% of the population experiences at least an episode during a lifetime.[1][2] Most cases of epistaxis are anterior in origin and arise from the Kiesselbach plexus. The SPA is the most common source of posterior epistaxis, which occurs less frequently. Management is challenging because the vessel is difficult to visualize and often produces brisk hemorrhage.[3] The SPA typically divides into 2 principal branches: septal and posterior lateral nasal. Additional branches are frequently present, and the intranasal course demonstrates considerable anatomic variability. Detailed knowledge of SPA anatomy and adjacent structures is essential for effective control of posterior epistaxis refractory to conservative measures.[4]