The extensor digitorum brevis island flap is a versatile and robust flap able to provide adequate bulk and coverage in soft-tissue defects of the lower limb. The donor-site deformity is limited to the necessary scar needed to approach and rotate the muscle. An anatomic study was performed in 10 fresh cadavers and consisted of two parts: study of the muscle flap itself, and examination of skin vascularization. Methylene blue and Salmon's mass (radiopaque) were injected through the three main arteries of the leg. Muscle and cutaneous staining were noted. Clinical applications of this flap are reported. These resulted in successful healing of the defect with good aesthetic and functional results on both recipient and donor sites. Long-term follow-up was maintained for up to 21 months.