In general, lower limb peripheral nerve injuries are much less common than those involving the upper limb and comprise approximately 25% of identified peripheral nerve injuries. Among lower limb nerves, the fibular (peroneal) and tibial nerves are commonly involved in nerve injury and neuropathy. The tibial nerve may be compromised in tarsal tunnel syndrome due to trauma or compression. Along its course in the lower limb, the tibial nerve may also be involved in various forms of neuropathy. Clinical presentation will vary depending on both the type and anatomic location of injury. There are a variety of approaches to the evaluation of a potential tibial nerve lesion or neuropathy. The appropriate studies to use in patient evaluation will depend on many factors with clinical presentation and the suspected clinical differential diagnosis being driving forces in the choice of conduction studies as well as the specific decisions regarding needle electromyography.