Abstract: Objective: To observe the effect of free anterolateral thigh flap on soft tissue defect repair. Methods: Twenty-five cases with defects in different parts of limb were repaired by anterolateral thigh flap transplantation. In all of these cases,there were 14 cases repaired simply with free anterolateral thigh flap,while 1 case associated with free fibula transplantation and 3 cases associated with thumb reconstruction simultaneously. Anterolateral femoral nerves with end branches were connected with nerves of accepted zone by anastomosis in 14 cases. Results: Twenty-three pieces of skin flap survived completely; vascular crisis and skin necrosis occurred in 2 cases; 1 case of palm and 2 cases foot back flap transplantation were treated by additional thinner surgery for their less satisfied shapes. Follow-up by 6 to 24 months,14 cases of flap transplantation with nerve anastomosis acquired different degrees of sensory nerve recovery,as five cases of S₂,four cases of S₃ and three cases of S₄. Twenty-three cases satisfied with the recovery of organ function and the appearance of the surgical sites. Conclusions: The free anterolateral thigh flap has many advantages,such as high survival rate and beautiful shape,so it is ideal for repairing tissue defects of limb flap and especially fit for young patients with cosmetic requirements.