The bilateral hypogastric nerves (HGn) are a major trajectory of sympathetic (pre- and postganglionic) and visceral afferent axons that supply the pelvic organs. These nerves link the superior hypogastric plexus (sympathetic; superficial to the distal abdominal aorta) with the inferior hypogastric plexus (mixed sympathetic-parasympathetic; in the pelvic cavity). The cellular components and microscopic organization of the HGn have been poorly defined in humans. Our aim was to define the anatomical organisation of the HGn and its vasculature from the macroscopic to microscopic levels. This was performed by applying immunohistochemistry with multi-scale imaging, including large-volume light sheet microscopy of cleared tissues (modified iDISCO method) and high-resolution confocal microscopy of cryosections. Our studies have visualised distinct vascular trajectories and axon fascicles contributing to the HGn. We also identified several large aggregates of tyrosine hydroxylase (TH) positive neurons (n=7714) embedded within the HGn. Additional neural markers visualised in cryosections of the HGn were identified in subclasses of ganglion neurons, synaptic boutons (potential preganglionic terminals) and axon tracts. These include neuropeptide Y, neuronal nitric oxide synthase, somatostatin, and vasoactive intestinal peptide. Putative afferent fibres (calcitonin gene-related peptide and substance P) traversed the HGn and occasionally encircled individual ganglion neurons, raising the possibility of direct sensory-motor communication at these sites. Multiple small intensely fluorescent (SIF) cell nodules were also observed close to neural tracts along the length of the HGn. This study has provided new insights into the structure, diverse neural elements and vascular supply within the adult human HGn.