Debridement of Fournier's gangrene frequently results in scrotal skin defects with exposed testes. Scrotal reconstruction is important for functional, cosmetic, and psychological reasons. Many methods of scrotal reconstruction have been described, including skin grafting, a variety of local and regional flaps, and tissue expansion. Preputial flaps are discussed in the literature most commonly for scrotal reconstruction in cases of congenital scrotal agenesis and for correction of buried penis. We describe a one-stage technique for scrotal reconstruction using a preputial skin flap in a patient with a large scrotal skin defect with an exposed testis following debridement for Fournier's gangrene. This is a simple technique that can be used alone or in combination with other local flaps to provide stable testicular coverage with good cosmesis.