In our cadaver dissection, the connection between the lateral calcaneal artery, the lateral tarsal artery, and the branch of the lateral plantar artery was corroborated, indicating possible reverse blood flow in the lateral calcaneal artery. The distally based lateral calcaneal flap has been successfully used in 2 patients. Vascular anatomy, indication, and technical points of the surgery as well as advantages and disadvantages of the flap are discussed.