The posterior tibial nerve innervates the skin of the postero-lateral side of the leg, the lateral aspect of the foot, and the sole of the foot. The cutaneous innervation of the posterior leg is shared between the nerves of the saphenous, superficial fibular, sural, and medial calcaneal branches; the tibial nerve contributes to the latter two. Posterior tibial nerve blocks are primarily used as regional anesthesia for procedures and manipulation, but are also utilized for management of conditions such as tarsal tunnel syndrome. This chapter will discuss the anatomy of the posterior tibial nerve as well as nerve block techniques including indications, contraindications, and complications.