Purpose <p>“Gonadal ganglion” is occasionally used to describe ganglia at the origin of the gonadal artery that give rise to gonadal branches. To evaluate the anatomical accuracy of this term and clarify the structure of gonadal innervation, anatomical examinations of the preaortic plexus and its ganglia were required.</p> Methods <p>Thirty-six sides from eighteen elderly cadavers were analyzed to study the anatomical and histological features of gonadal innervation.</p> Results <p>The intermesenteric plexus was found to form thick bilateral intermesenteric trunks accompanied by a thin preaortic plexus. Paucicellular preaortic ganglia containing only a few ganglion cells were widely distributed throughout the plexus, whereas dense preaortic ganglia (DCGs) were consistently located on each trunk. Although a clear interaction between the preaortic ganglia and both typical and atypical gonadal arteries was noted, several findings raise concerns about the anatomical validity of the term “gonadal ganglion.” First, 10 of 33 (30.3%) typical gonadal arteries lacked a DCG at the artery’s origin. Second, 15 of 40 DCGs (37.5%) contributed to gonadal innervation regardless of the gonadal artery’s origin. Although gonadal branches consistently followed the gonadal artery in the paraaortic region, their association with intermesenteric ganglia or gonadal artery origin in the preaortic region was variable.</p> Conclusion <p>Regardless of their location on the gonadal artery, the surrounding ganglia contribute only a few branches to the gonads but supply many branches to other structures. “Gonadal ganglion” should not be used to describe a ganglion with a single function. If necessary, it should be termed the “aortico-gonadal ganglion”.</p>