Finding the ventrogluteal injection site

Key points

• 01What the site actually is. The ventrogluteal site sits on the side of the hip, over the gluteus medius and gluteus minimus muscles, not on the fleshy part of the buttock. The bony landmarks that box it in are the greater trochanter of the femur, the anterior superior iliac spine and the iliac crest.
• 02Why nursing guidance moved here. The area is described in nursing texts as free of large nerves and vessels, with the sciatic nerve well away from it. A 2023 systematic review in Nurs Open compared adverse effects at the dorsogluteal and ventrogluteal sites and reported fewer complications with the ventrogluteal approach.
• 03The hand landmark in one sentence. Heel of the opposite hand on the greater trochanter, index finger on the anterior superior iliac spine, middle finger spread back along the iliac crest, inject in the middle of the V. Left hand for the right hip, right hand for the left hip.
• 04Feel the bone, do not eyeball the skin. Every part of this landmark is bony. If you are looking at the surface of the skin and picking a spot that looks about right, you are not landmarking. Press until you feel the trochanter roll under your hand and the front point of the pelvis under your fingertip.
• 05Position changes how easy it is. Side-lying with the top knee drawn up is the position most nursing references describe, because it relaxes the muscle and opens the landmark. A 2026 study in the Journal of Research in Nursing compared standing and lying positions for pain and complications at this site, so the choice is not cosmetic.
• 06Needle length is a body-shape question. Work in the Journal of Clinical Nursing has looked at how gender, body mass index and body shape change whether a standard needle actually reaches muscle at the gluteal sites. That is why length is prescribed for you rather than read off a chart. See our intramuscular needle size guide.
• 07Volume limits come from the product, not the site. Nursing references give a larger volume allowance at this site than at the deltoid, but the number that governs your injection is the one on your medication label and the one your prescriber gave you. Splitting a large volume across two sites is a clinician decision.
• 08The aspiration question has moved. Pulling back on the plunger before injecting used to be taught everywhere. Studies including a 2023 paper in Clinical Nursing Research at this specific site, and a 2025 JBI systematic review, have questioned the benefit. Local protocols vary, so do what your service told you.
• 09Slow injection is a comfort measure with evidence behind it. The nursing literature consistently associates a slow, steady plunger with less pain than a fast push. There is no prize for finishing quickly, and a rushed plunger raises pressure in the tissue, which is what people describe as the deep ache afterwards.
• 10Alternate sides and write it down. If you are on a repeated intramuscular course, alternate hips and record which side you used. Repeated injection into the same patch of muscle is associated with hardened tissue and unreliable absorption. Our injection record guide has a layout that includes a side column.
• 11This is not a GLP-1 site. Ozempic, Wegovy, Mounjaro, Zepbound and the rest of the weekly GLP-1 pens are subcutaneous. Putting one into muscle changes how fast it is absorbed and is not what the label describes. Our post on injecting into muscle instead of fat covers what to do if it happens.
• 12Ask to be signed off before you do it alone. Subcutaneous self-injection is reasonable to learn from a handout. Intramuscular landmarking is not, because the whole safety margin comes from your fingers finding bone. Ask the nurse who trains you to watch you find the site twice and correct you.

Pre-injection checklist

• ✓The ventrogluteal site is an intramuscular site. GLP-1 medications such as Ozempic, Wegovy, Mounjaro and Zepbound are subcutaneous and do not belong here. Our post on intramuscular versus subcutaneous injection explains the difference.
• ✓Landmarking is a hands-on skill. Have a nurse or prescriber watch you find the site and sign off before you use it at home. A page cannot confirm that your fingers are in the right place.
• ✓Needle length for this site depends on your build. Nursing references pair the ventrogluteal site with a longer needle than a subcutaneous injection, and the correct length is a clinician decision, not a guess.
• ✓Check your medication label for the maximum volume per site and whether the route is intramuscular at all. Some products are subcutaneous only.
• ✓This is a technique reference, not medical advice. Your medication, your route, your dose and your needle are set by your prescriber.

Step-by-step guide

1. 1

   Wash your hands and lay out the supplies

   Wash with soap and water for at least 20 seconds and dry on a clean towel. Lay the syringe, needle, alcohol pads and gauze on a clean surface, and open the sharps container first so the used needle has somewhere to go the second it comes out.

   Pro tip

   Always check the fluid is clear and colourless before injection.
2. 2

   Draw up the dose and change the needle if instructed

   Draw the volume your prescriber set, following the routine in our guide to drawing up medication from a vial. If your instructions say to swap the drawing-up needle for a fresh injection needle, do that now, because a needle that has been through a rubber stopper is duller.

   Pro tip

   Always check the fluid is clear and colourless before injection.
3. 3

   Lie on your side with the top knee bent

   Side-lying with the upper leg drawn forward and the knee bent is the position nursing texts describe for this site, because it relaxes the gluteus medius. A tense muscle hurts more and makes the landmark harder to feel. Standing is possible but relaxation is the point.

   Pro tip

   Always check the fluid is clear and colourless before injection.
4. 4

   Put the heel of your opposite hand on the greater trochanter

   For the right hip you use your left hand. Rest the heel of that hand on the bony bump at the top of the thigh, the greater trochanter, which you can feel by rolling the leg slightly. Point your fingers toward the head. This is the anchor for everything that follows.

   Pro tip

   Always check the fluid is clear and colourless before injection.
5. 5

   Place your index finger on the anterior superior iliac spine

   Spread your index finger forward until it sits on the front bony point of the hip, the anterior superior iliac spine. That is the front corner of the pelvis, the one you can find just under the waistband. Keep the heel of the hand on the trochanter while you do it.

   Pro tip

   Always check the fluid is clear and colourless before injection.
6. 6

   Spread your middle finger back along the iliac crest

   Open your middle finger away from the index finger and slide it back along the ridge of the iliac crest. Your two fingers now make a V, and the centre of that V, over the flat of the muscle, is the ventrogluteal site described by the nursing literature.

   Pro tip

   Always check the fluid is clear and colourless before injection.
7. 7

   Mark the spot and clean it

   Note where the centre of the V falls, then wipe that area with an alcohol pad in one direction and let it air-dry for at least ten to fifteen seconds. Injecting through wet alcohol is the most common avoidable cause of stinging. Do not fan or blow on it.

   Pro tip

   Always check the fluid is clear and colourless before injection.
8. 8

   Insert the needle at 90 degrees in one movement

   Hold the syringe like a dart, steady the skin with your other hand, and put the needle in at a right angle to the skin surface in one smooth movement. Hesitating is what makes an intramuscular injection hurt. The needle goes in far enough that the hub is close to the skin.

   Pro tip

   Always check the fluid is clear and colourless before injection.
9. 9

   Follow your local protocol on aspiration, then inject slowly

   Some services still ask you to pull back on the plunger for a few seconds at gluteal sites and abandon the injection if blood appears. Recent reviews question whether that step adds anything at this site. Follow the instruction you were given, then push the plunger slowly and evenly.

   Pro tip

   Always check the fluid is clear and colourless before injection.
10. 10

    Withdraw, press and dispose

    Wait a few seconds, then pull the needle straight out along the line it went in. Press a gauze square on the spot without rubbing. Put the whole syringe with the needle attached into the sharps container. Do not recap. Write down the date, the side and the site.

    Pro tip

    Always check the fluid is clear and colourless before injection.

After the injection

• Press a gauze square on the site for a few seconds without rubbing. Rubbing an intramuscular site is associated with more leakage and soreness.
• Expect the area to ache for a while. Gentle movement of the leg tends to help more than sitting still.
• Record the date, the medication, the volume and which hip you used, so the next injection goes on the other side.
• Put the syringe in the sharps container with the needle attached and never recap it.

Common mistakes

Frequently asked questions

Sources

1. Ogston-Tuck S. 2014. Intramuscular injection technique: an evidence-based approach. Nursing Standard 29(4):52-59.
2. Adverse effects of dorsogluteal versus ventrogluteal intramuscular injection: a systematic review. Nursing Open, 2023.
3. Investigation of the Necessity of Aspiration During Intramuscular Injection in the Ventrogluteal Site. Clinical Nursing Research, 2023.
4. Influence of gender, BMI and body shape on theoretical injection outcome at the ventrogluteal and dorsogluteal sites. Journal of Clinical Nursing, 2018.
5. World Health Organization. Best practices for injections and related procedures toolkit.