Nine patients with extensive soft tissue defect of the upper extremity treated by the latissimus dorsi myocutaneous island flap are presented. The availability of a large amount of distant tissue based on a long pedicle used in a single stage makes it an ideal flap for reconstruction of such defects. This flap has also been used to cover defects of the distal forearm after carefully dissecting the thoracodorsal vessels right up to the axillary vessels. There have been no complications in these cases.