Early Reconstruction of the soft tissue defect is an integral part of the management of the complex lower extremity injuries. Coverage of the defects with exposed bone, tendon, vessels, and nerves remains a challenge and the difficulty is more pronounced in the lower third of the leg. Achievement of soft tissue cover as a one stage procedure not only promotes early healing but also reduces the overall morbidity in these patients. Sural artery flap is a time tested reconstructive choice with wide range of clinical applications including distal leg, ankle and proximal foot. The flap has a constant blood supply, based on simple surgical principle and the procedure is associated with minimal morbidity. The versatility of the sural artery flap in reconstructing soft tissue defects on the lower limb defects has made this flap as a popular choice among the reconstructive surgeons.