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A 7 cm \u00d7 4 cm fasciocutaneous flap based on a posterior tibial artery perforator (PTAP) from the left posterior leg was harvested to reconstruct a floor of the mouth defect. The donor\u2010site defect was closed primarily. The flap survived in its entirety. No donor or recipient site complications occurred. The patient tolerated a regular diet at 3\u2010month follow\u2010up with normal speech and leg function. To our knowledge, there has been no previous report on the use of the PTAP flap for floor of mouth reconstruction. Our experience has shown the PTAP flap could be one of options for small defects. \u00a9 2011 Wiley Periodicals, Inc. 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