Background: Reconstruction of extensive defects of the lower abdomen, trochanter, groin and knee without using complex microsurgery is a reconstructive challenge. Pedicled anterolateral thigh (ALT) flaps offer many advantages over other regional flaps for this purpose, such as the large skin area and soft-tissue availability, a remarkable pedicle length, and possessing multiple components and reliability. We present our experience of using pedicled ALT flaps for repairing various defects. Methods: From September 2006 to October 2012, 32 pedicled ALT flaps were used in 31 patients for defects of the lower abdomen (3 patients), trochanter (26 patients), groin (1 patient) and knee (1 patient). Eighteen of the patients were male (58%) and the age ranged from 22 to 103 years. The flap size ranged from 8X5 cm (40 cm2) to 9X20 cm (180 cm2). Results: Satisfactory coverage was achieved in all patients. Conclusions: Our experience has shown the wide arc of rotation, large skin replacement potential, multiple components and reliability of pedicled ALT flaps.