First web space widening is crucial in the reconstruction of severe thermal burn contracture of the hand. A thin, pliable flap with a long vascular pedicle is required. We describe our experience with the reversed posterior interosseous artery flap in nine patients over a 5-year period for this surgical indication. All flaps survived and we were able to achieve good functional and cosmetic outcomes with minimal donor morbidity. We believe that the reversed posterior interosseous flap is the excellent option for the first web space reconstruction.