Background: Preservation of foot and leg mobility is critical in debilitating traumatic and pathological conditions, such as diabetes and peripheral vascular diseases, which lead to significant foot and leg defects and potential amputations. The supramalleolar flap offers a promising solution for covering defects in the dorsal foot, ankle, and leg, providing a reliable and robust method to preserve tissue and function. Methods: This study reviewed patients with dorsal foot, ankle, and leg defects treated at our center from november 2022 to august 2024. The inclusion criteria focused on various defects caused by trauma, diabetes, or post-surgical conditions, excluding those with peripheral vascular disease or severe cardiac illness. The study utilized various assessment tools, including arterial vascular doppler and computed tomography and angiography, to ensure the viability of the flap coverage. Results: The study successfully demonstrated the efficacy of the supramalleolar flap in 12 patients with wide range of defects. The flap showed a high survival rate with only one instance of partial necrosis. Most patients showed good postoperative recovery, with the flaps providing satisfactory coverage without significant complications. Conclusion: The supramalleolar flap is an effective and reliable option for covering defects in the anterior aspect of dorsal foot, ankle, and leg areas. It offers a significant advantage in reducing the risk of amputation and preserving mobility, particularly in patients who are not candidates for more complex reconstructive options due to systemic health issues.