How to find and assess a pedal pulse

9 tips to quickly find a patient’s pedal pulse for checking lower extremity circulation

April 29, 2025 10:37 AM •

Greg Friese, MS, NRP

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Assess for a dorsalis pedis pulse to check distal circulation.

Greg Friese

2 of 2:

Assess for a posterior tibial pulse to check distal circulation.

Greg Friese

Finding a pedal pulse is part of the trauma patient assessment and is performed before and after lower extremity splint application, as well as long backboard immobilization. Assessing a pedal pulse is part of the ongoing assessment for an immobilized patient or a patient wearing a lower extremity splint. During hospital care, nurses and CNAs, might need to find and document lower extremity circulation for bed-bound patients.

| Scroll to the end of the article for a pedal pulse FAQ

Locating a pedal (foot) pulse can be difficult even in healthy patients. Use these tips to find and refind a patient’s pedal pulses:

1. Radial pulse first

Assess the patient’s radial pulse rate and rhythm so you know what you are seeking and palpating in the patient’s foot.

2. Bare the patient’s skin

Move shoes, socks, tights and anklets out of the way to expose the patient’s skin.

3. Reposition the foot to normal

Move, if not compromised by injury, the patient’s foot towards the normal anatomical position.

4. Two possible pedal pulse positions to check

Check for either the dorsalis pedis pulse (on the top of the foot) or the posterior tibial pulse (located behind the medial malleolus — the ankle bone).

5. Visualize skin for pulsation

For dorsalis pedis, first, visualize the patient’s bare skin because you might see the skin pulsating above the artery. If you are unable to see anything, hold two or more fingers lightly against the skin of the foot. Start your search just above the space between the great (big) toe and the second toe. Gently feel for a pulse as you move your fingers up from the toes towards the lower leg until you locate the pulse.

6. Use two or more fingers

For posterior tibial — on the medial side of the ankle — use two or more fingers. I find that more pressure is needed to find this pulse.

7. Try the other leg

If you are unable to find the pedal pulse on one leg, switch to the patient’s other leg. Knowing the location of one pulse might help you find the other.

8. Mark the pedal pulse location

Once you have found a pedal pulse, consider using a ballpoint or felt pen to make a light mark at the pulse location to make reassessment easier.

Dorsalis pedis pulse location marked with a pen — Assess for a dorsalis pedis pulse to check distal circulation. Mark the pulse location for easier reassessment.

9. Check foot temperature and color

Finally, if the patient’s foot is warm with normal color, it is adequately perfused.

What else works well for finding a pedal pulse? Why might a pedal pulse be absent or diminished?

Pedal Pulse

Learn about the pedal pulse: where to find it, how to assess it, and what it means for circulation and vascular health.

What is a pedal pulse and why is it important? +

A pedal pulse refers to the pulse felt in the foot, typically the dorsalis pedis or posterior tibial artery. It is an important indicator of blood flow to the lower extremities. Assessing pedal pulse helps evaluate peripheral circulation and can signal issues like peripheral artery disease (PAD) or poor vascular health.

How do you check for a pedal pulse? +

To check the pedal pulse, gently press your fingers on the top of the foot near the center (dorsalis pedis artery) or behind the inner ankle (posterior tibial artery). If you cannot feel it easily, try both feet and compare for symmetry.

What does it mean if a pedal pulse is weak or absent? +

A weak or absent pedal pulse can indicate reduced blood flow to the feet, often due to narrowed or blocked arteries. This may be a sign of peripheral artery disease, diabetes-related circulation issues, or other vascular conditions. Early detection is important to prevent complications like ulcers or tissue damage.

Where is the pedal pulse located on the body? +

The pedal pulse is located in the foot and is typically assessed at two main sites: the dorsalis pedis artery and the posterior tibial artery. The dorsalis pedis pulse can be felt on the top of the foot, usually along an imaginary line between the first and second toes, just lateral to the extensor hallucis longus tendon. The posterior tibial pulse is found behind the medial malleolus (the bony prominence on the inner ankle), slightly above the heel. Both pulse points are superficial and play an important role in evaluating lower limb circulation.

What conditions can affect the pedal pulse? +

Several health conditions can affect the pedal pulse, including peripheral artery disease (PAD), diabetes, atherosclerosis, and trauma to the lower limbs. Cold temperatures, swelling, or obesity may also make the pulse harder to detect, even if circulation is adequate.

How is pedal pulse used in assessing peripheral circulation? +

Healthcare providers use the pedal pulse to evaluate peripheral circulation, especially in patients with diabetes, vascular disease, leg pain or lower limb injury. A strong, regular pulse usually indicates healthy blood flow, while a diminished or absent pulse may prompt further vascular assessment or imaging.

Can you still have good circulation without a detectable pedal pulse? +

Yes, it’s possible to have adequate circulation even if a pedal pulse is not easily felt. Factors like thick skin, edema, or anatomical variation can make the pulse hard to detect. However, if there are other symptoms of poor circulation, further tests may be needed.

Education

How to find and assess a radial pulse

5 tips to quickly find a patient’s radial pulse for vital sign assessment

April 29, 2025 02:46 PM

Greg Friese, MS, NRP

This article, originally published December 7, 2009, has been updated with new images and additional information.

Greg Friese, MS, NRP

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.