Abstract： Objective To study the methods and therapeutic effect of coverage the soft tissue defect in the foot and ankle with neurocutaneous sural artery island flap.Methods 30 patients had been reconstructed foot and ankle soft-tissue defects with neurocutaneous sural artery island flap,the area of soft tissue defect from 2.0 cm × 3.5 cm～ 8.0 cm× 16.5 cm,the flaps were designed with the size measuring 2.5 cm × 4.0 cm to 8.5 cm × 18cm.Results 26 flaps survived completely and 4 with partial or margin necrosis,the wound infection occurred in 6 patients and were treated with dressing,shin graft and antibiotic drug.Conclusions Sural neurocutaneous island flaps are easy to separate.Major arteries are not injured.It is the ideal flap to repair the soft tissue defect around ankle and foot,the texture,color and contour of the flap is similar to recipient area.