Our first 100 free flap operations are reviewed. The location and cause of the defects requiring free flaps, the flaps used, and the outcome are tabulated. The lower leg was the most common site of defect. Osteomyelitis and trauma were the most common causes. The latissimus dorsi and tensor fascia lata were the most useful flaps. Of the 15 patients with failed flaps, wound closure was accomplished by other methods in 13 and 2 underwent amputation. One of the patients with a successful free flap ultimately underwent amputation because of recurrent osteomyelitis.