Free-tissue transfer has become an popular method for the management of large lower extremity soft-tissue defects. The success rates of free tissue transfer have been greater than 90%, with the most recent reports exceeding 95%. All authors attributed their success to better donor sites and improved microsugical techniques. It demonstrates that refinement in the donor site selection plays an important role in the free-tissue transfer. The latissimus dorsi and rectus abdominis muscles remain the preferred flaps for coverage of defects of exposed bone, artery, nerve, or tender in the lower extremity. The main problem with using muscle flaps is that functional deficits of muscle harvest are real but have not been adequately studied. Moreover, they also usally need a donor site in the thigh to provide skin for grafting the primitive donor site. The anterolateral thigh flap based on the descending branch of the lateral circumflex femoral vessel is one of the musculocutaneous or septocutaneous flaps in the thigh, and suitable for coverage of defects that require a relatively large flap, especially for defects in the lower extremity. Since 1983, we have transferred 72 anterolateral thigh flaps for reconstruction of lower extremity. The results were satisfactory. Only one case resulted in a failure due to tiny cutaneous perforators. This study represents our clinical experience and applied anatomy of the flap.