OBJECTIVE: To present a series of perineoscrotal and vaginal defects reconstruction with the use of anterolateral thigh flap.METHODS: We present a series of 11 patients in whom we used pedicled thigh flaps (10 anterolateral thigh flaps and 1 anteromedial thigh flap) to cover defects of perineum, scrotum, and vagina. Ten patients had perineoscrotal defects and 1 patient had vaginal agenesis.RESULTS: Age group ranged from 26 to 79 years. The size of the flaps ranged from 105 cm² to 220 cm². The vascular pedicle length ranged from 10 cm to 12 cm. Stable closure was achieved in every patient. There were no complications from the donor site. In 1 patient, we found only 1 perforator at the superomedial edge of the flap that originated from the medial circumflex femoral artery; hence, in this patient, we used an anteromedial thigh flap as a salvage procedure.CONCLUSION: With versatility in their design and low donor site morbidity, these flaps present an option in the armamentarium of the reconstructive surgeon for the coverage of defects at the perineoscrotal and vaginal area.