Abstract: Objective: To evaluate the long-term effects of vascular pedicled iliac periosteal flap graft on Perthes disease. Methods: Fifty-three hips of 49 patients with Perthes disease were treated with vascular pedicled iliac periosteal flap. All cases were followed-up for 3 to 16 years. According to the lateral pillar classification, 19 hips were B type, 23 hips as B/C type and 11 hips as C type. Results: The Harris hip scores were obviously improved after treatment(P ＜ 0. 01) . According to the Stulberg classification system modified, 39 hips were StulbergclassⅠor Ⅱ grade including 16 hips as Herring B type, 19 hips as B/C type and 4 hips as C type. Ten hips were Stulbergclass Ⅲ grade including 3 hips as Herring B type,3 hips as B/C type and 4 hips as C type. Four hips were Stulbergclass Ⅳ grade including 1 hip as B/C type and 3 hips as C type. There was not statistical difference between the Stulberg grades of B and B/C type postoperation(P ＞ 0. 05) . Compared with C type, the Stulberg grades of B and B/C type had significantly different(P ＜ 0. 01) . The prognosis of 34 hips in male(41 hips) and 5 hips in female(12 hips) were StulbergclassⅠor Ⅱgrade. The prognosis of 32 hips in 4 to 7 years children(37 hips) and 7 hips in 8 to 12 years children(16 hips) were StulbergclassⅠor Ⅱgrade. Conclusions: The effects of treating Perthes disease with vascular pedicled iliac periosteal flap graft are good. The lateral pillar classification, the age and gender of patients can help us to evaluate prognosis.