Objective To explore the clinical efficacy of proximal latissimus dorsi (LD) flap in breast reconstruction and simultaneous-repair of axillary fossa deformity after axillary lymph node dissection (ALND). Methods From 2009 to 2014, 23 patients received unilateral breast reconstruction after modified radical mastectomy. During the LD mycutaneous breast reconstruction, the insertion of LD was cut off and the proximal LD was rotated to fulfill ipsilateral axillary fossa. Results The axillary contour deformity were all successfully restored, with no local bulge or flap loss. And the results were stable in the follow-up for 0.5 to 2.5 years. The patients were all satisfied. Conclusion Using proximal LD flap for breast reconstruction and simultaneous-repair of axillary fossa deformity is safe, easy and effective. And it is worthy of application.