Objective    To explore survival rate and survival mechanism of the modified double stem arterialized venous skin flaps.    Methods    40 venous skin flaps of hind limbs with two vein trunks and size of 2.0cm×3.0cm were obtained from New Zealand white rabbits. The flaps were randomly divided into two groups: the control group and the study group. For heterotopic replanted arterialized venous skin flap in the control group, central artery and central vein at the  back of rabbits'ear were anastomosed. For study groups, "opening groove" were performed (fat tissues of flap were cut to reach subdermal vascular plexus and keep its integrity by ligating all communicating branches）. Survival of all skin flaps was recorded.   Results   In study group, 14 skin flaps survived, while 4 skin flaps had partial necrosis and 2 complete necrosis. In the control group, 4 skin flaps survived, 5 skin flaps had partial necrosis and 11 complete necrosis. There was significant difference in the survival rate between two groups (P＜0.05).    Conclusions   Modification of arterialized venous skin flap is useful to bleed into micro-circulation and reach the balance of arterial supply and venous drainage. It may improve the survival rate of arterialized venous skin flap.