Objective To explore a visualization method to assess the tissue perfusion during breast reconstruction. Methods From July 2014 to January 2015, 4 patients with breast cancer received breast reconstruction after mastectomy by using intraoperative ICG angiography in order to determine the width and height of flap for flap shaping. Results The results determined by ICG angiography was correlated well with clinical findings. Among 4 cases, 3 cases had good perfusion, 1 case developed partial blood circulation disorder. Conclusion The use of ICG angiography during postmastectomy breast reconstruction may decrease the incidence and severity of flap necrosis, and is a reliable tool for breast reconstruction.