AbstractThe aim of this study was to review the literature on the posterior gastric artery, estimate its prevalence and summarize its reported origins. The databases Pubmed, Scopus, Web of Science and Google Scholar were searched to find all studies describing the prevalence and origin of the posterior gastric artery. Pooled prevalences were estimated using a random effects model. Thirty‐eight studies with a total of 3366 subjects were included in the analysis. The overall prevalence of the posterior gastric artery was 57.4% (95% CI = 49.1%–65.7%). The prevalence of the posterior gastric artery was significantly higher in surgical studies than in cadaveric and angiographic studies. There were no differences in prevalence between multi‐detector computed tomography studies and cadaveric studies, nor were there differences when comparing geographical location or study size. Origin data were extracted from 34 studies, with a total of 1533 cases. The posterior gastric artery arose as a single vessel from the splenic artery in 1160 cases (pooled prevalence 86.5% [95% CI = 78.5%–94.7%]), from the superior polar splenic artery in 339 cases (pooled prevalence 11.8% [95% CI = 3.7%–19.9%]) and from other origins in 50 cases (pooled prevalence 0.27% [95% CI = 0.00–0.71%]). The posterior gastric artery is present in 57.4% of cases and most commonly arises from the splenic artery. It should be identified before gastric resections as it may be an important source of blood to the gastric stump. Multi‐detector computed tomography has sufficient sensitivity to detect it before surgery.