Over a period of 10 years 57 pelvic pressure sores of 47 para- and tetraplegic patients were covered operatively with a muscle flap at the Co-Operative Trade Association Hospital for Accidents, at Tübingen, Germany. 39 patients with 49 muscle flap-covered decubiti were seen in a follow-up examination. Despite many postoperative complications--not uncommon for septic patients--there was a high rate of complete healing (94%) of the pressure sores within a short period of rehabilitation. Indeed one cannot prove the superiority of the muscle flaps over cutaneous and fasciocutaneous flaps because of the missing statistical comparability and correlation capability of the results with other studies. In our opinion muscle flaps in the pelvic area seem to be advantageous to cutaneous and fasciocutaneous flaps.