Objective　To report clinical effects of the upper perforator flap of the medial malleolus pedicled with the posterior tibial artery on repairing skin and soft tissue defect of foot and ankle.　Methods　From Feb. 2003 ~ Feb. 2010, 22, patients with skin and soft tissue defect of foot and ankle were treated with the upper perforator flap of the medial malleolus pedicled with the posterior tibial artery. Flap area was about 10cm ×7cm ~ 15cm×11cm, and the donor field was treated with the lower abdomen area full-thickness skin graft.　Results　The flaps of 22 patients primarily survived, as well donor wounds primarily healed. The follow-up extended 6 to 36 months, averagely 12 months. Flaps appeared well, with sensory recovery of S2~S3+, and satisfied function recovery of foot walking. Donor areas recovered well, without cicatricial contration.　Conclusions　The upper perforator flap of the medial malleolus pedicled with the posterior tibial artery can be used to repair skin and soft tissue defects of foot and ankle, for its stable anatomic features and convenient operative procedure.