The Chinese forearm flap is vascularized by the radial artery and may be used as an island or a free flap. Used as an island flap, the pitfalls of the microsurgical procedures required for a free flap, may be avoided. Vascular anastomosis is easily performed owing to the large diameter of the vessel. The possibility of using it as a composite flap with fascia, tendons, muscle, bone or nerve makes this flap a "must" in reconstructive surgery of the hand. A series of 33 cases was reviewed in an attempt to summarize their indications and contraindications respectively.