The levator ani is the largest component of the pelvic floor. It forms a dome-shaped muscular sheet and is composed of three muscles:

• Puborectalis

• Pubococcygeus

• Iliococcygeus

The levator ani muscles attach to the internal surfaces of the pubic bodies and rami anteriorly, ischial spines laterally, and coccyx and sacrum posteriorly. Muscles also attach to the arcus tendineus, which lies on the lateral and anterior aspect of this area and goes from the inner anterior aspect of the inferior pubic ramus to the ischial spine along the inferior border of the obturator internus muscle and is a condensation of the obturator fascia.

Note: the puborectalis sometimes is regarded as a component of the external anal sphincter and distinct from levator ani muscles because of its developmental and histological differences.