Objective:To explore the applied anatomy of sural nerve and the risk of injury in the related operative approach.Methods:Using "腓肠神经" "解剖" "手术入路" and "sural nerve" "anatomy" "surgical opproaches" as the key words to identify the articles about the clinical applied anatomy of sural nerve in CNKI Data, WangFang Data, SinoMed and PubMed Data from January 2000 to July 2019. We searched the literatures related to the anatomy of the sural nerve, the posterior lateral approach of the ankle fracture, the L-shaped approach to the calcaneal fracture, the sacral sinus approach to the calcaneal fracture, and the fifth humeral basal fracture approach. Then we summarized the anatomical relationship between the four surgical approaches and the sural nerve.Results:A total of 999 literatures were seached, and 34 literatures were finally included after excluding the literatures that did not conform to the content, could not obtain the full text, repeated studies or which had design defects. The sural nerve has many types of anatomical variations, and its walking area is closely related to the four surgical approaches: the posterior lateral approach of the ankle fracture, the L-shaped approach to the calcaneal fracture, the sacral sinus approach to the calcaneal fracture, and the fifth humeral basal fracture approach.Conclusions:Properly mastering of the anatomical characteristics of the sural nerve before surgery is very important to the choice of surgical approach for foot and ankle fractures and to reducing the risk of sural nerve injury during surgery.