Free tissue transfer was used for the reconstruction of soft tissue defects in 94 children. Of the 127 procedures performed, the latissimus dorsi, scapular skin, lateral arm skin, rectus abdominis, and gracilis were used with the greatest frequency. The microsurgical success rate was 96%. Microsurgical failures were repeated, successfully, and in all cases the limbs were salvaged. Other than having to deal with decreased vessel size and avoiding continuous suture lines, there appears to be little difference in technique or outcome of free tissue transfer when compared to adults.