At the Plastic and Reconstructive Surgery Department of Perugia, 52 patients were examined by color flow duplex scanning, in order to study rectus abdominis myocutaneous flap vascular supply before surgical procedures. This ultrasound technique permits a precise and accurate measurement of blood flow volume and velocity within the epigastric arteries (which represent the superior and inferior vascular pedicles of the flap) and makes it possible to detect the exact location of the perforating branches with their cutaneous distribution. This preoperative evaluation, pointing out vascular pathologies which contra-indicate the use of rectus abdominis flap, can be considered a great help for the reconstructive surgeon in the choice of the operative procedure and can surely lead to a significant decrease in postoperative complication rate.