Objective To explore the clinical effect of reversed peroneal perforator superficial sural nerve nutrient vessel flap pedicled with peroneal vessel for reconstruction of soft tissue defects in ankle and foot.Methods Twenty five patients with soft tissue defects in ankle and foot were treated by superficial sural nerve nutrient vessel flap.Nineteen flaps were supplied by the ascending branch of the terminal peroneal perforator,while 6 flaps were supplied by the descending branch of the terminal peroneal perforator.The area of tissue loss ranged from 4 cm × 3 cm and 10 cm × 9 cm,and the flaps were measured from 6 cm × 5 cm and 11 cm × 9.5 cm in size.Results Twenty three flaps survived completely,while 2 flaps occurred necrosis distally which were treated by debridement and skin graft coverage.Mild swelling was observed in the early postoperative days,without severe venous congestion.The follow-up ranged from 6 to 18 months,and the cosmetic and plastic aspects of the flaps were evaluated as acceptable in all cases.The donor site healed uneventfully.Conclusion The reversed superficial sural nerve nutrient vessel pedicled with flap peroneal perforator provides a reliable tool for repairing soft-tissue defects of ankle and foot.