INTRODUCTION: Forearm flaps can be used safely as a free tissue transfer with great safety and versatility. Forearm skin is thin and the vascular anatomy is constant. Although radial foream flap is the most popular forearm flap, several flaps can be harvested based on different pedicles. Anterior interosseous flap is one of those alternatives, however it has not gained popularity among other options. This flap is harvested on the dorsal side of the forearm based on the dorsal septocutaneous branch of the anterior interosseous artery. MATERIALS AND METHOD: Between January 2002 and January 2006 ten free anterior interosseous flaps were performed. Five of them were used for hand coverage including digits and the dorsum of the hand, five flaps were used for head and neck reconstruction. Two donor sites were closed directly and the others required skin graft. RESULTS: All flaps survived completely except one marginal loss. Reexploration was done in one patient because of hematoma and partial loss was observed in this patient. All reconstructions were successful and the patients were satisfied with the reults. CONCLUSION: The advantages of free anterior interosseous flap are as follows; 1) major arteries are preserved, 2) good color and texture match especially for hand defects, 3) vascular pedicle is large and long enough, 4) composite flaps are possible, 5) fascial flap can be harvested to reduce donor site morbidity. The disadvantages of this flap are unsigtly donor are scar which is more or less common in all forearm flaps and technically demanding dissection. Based on our experience, free anterior interosseous flap is a versatile option for upper extremity and head and neck reconstruction in selected group of patients.