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Background: In 1955, the pioneering work of Robert Desproges-Gotteron greatly improved our understanding of the anatomy of the human vasculature, in particular the discovery of the Artery of Desproges-Gotteron (ADG). The aim of this study is to provide an in-depth analysis of the ADG through a comprehensive literature review and to provide information on its anatomy and neurosurgical implications. Method: This evaluation was conducted through a comprehensive analysis of the literature, focusing on publications related to the ADG. A search of electronic databases, including PubMed, ScienceDirect, and Web of Science, was performed from the inception of each database until July 2025. The search strategy employed specific keywords and phrases such as “Artery of Desproges-Gotteron,” “cone artery,” and “radiculomedullary arteries.” Results: The ADG is a branch of the internal iliac artery that supplies the conus medullaris. Eight articles met the inclusion criteria and investigated the clinical significance of the ADG. The main pathology involved was AVF in approximately 5 (62.5%) patients and lumbar disc prolapse in 2 (25%) patients. Three patients (37.5%) presented with cauda equina syndrome, while the others presented with a combination of motor weakness and sphincter dysfunction. Approximately 4 (50%) patients were treated by endovascular interventions, while 2 (25%) patients had disc prolapse resulting in ADG vascular compromise. Conclusion: The ADG is essential in neurosurgery and neuroradiology for precise intervention in spinal arteriovenous malformation surgery. Compression of the artery can lead to conus medullaris syndrome. Understanding its variability is critical for neurosurgeons to demonstrate continuous improvement in patient care.