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A 15\u2010year\u2010old female patient with venous malformation of the left 3rd finger was treated by radical excision of the tumor including involved skin, distal phalanx, and nail bed followed by reconstruction with free medial plantar artery perforator flap and split thickness nail bed graft from the great toe. Twenty\u2010nine months after surgery, the reconstructed finger showed a acceptable aesthetic result without tumor recurrence and excellent restoration of motor function. This method can be considered as an useful alternative option for management of the digital venous malformation in other digits except the thumb. Indications and technical aspects of this method are discussed in this report. \u00a9 2011 Wiley Periodicals, Inc. 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