In the setting of traumatic injury, obtaining suitable coverage to salvage a below-the-knee amputation has been performed by using a variety of tissue flaps, including the fillet of foot free flap. This flap is a free tissue transfer that utilizes the soft tissue of the foot for stump coverage. In this report, we present a 15-year follow-up of a patient with a fillet of foot free flap to demonstrate its applicability and long-term efficacy. We also discuss technical aspects for performing this procedure. In this follow-up, we have found the flap to be extremely durable, even when placed in the weight-bearing position of the stump, and also lacking many of the usual complications associated with the weight-bearing portion (e.g., blisters, ulcerations). We conclude that the fillet of foot free flap is an excellent salvage flap for providing long-term length, coverage, and durability in an amputated, weight-bearing extremity.