Background:Due to a lack of soft tissue, the foot and ankle are vulnerable to infections and injuries. The present study was conducted to compare free flap with pedicled flaps for coverage of defects of the leg or foot. Materials & Methods:60 patients of defects of the leg or foot of both genderswere divided into 2 groups of 30 each. Group I patients were managed with free flap and group II were managed with pedicled flaps. Parameters such as etiology, wound bed inflammation, partial necrosis, complete necrosis, postoperative wound infection and comorbidities was recorded. Results: In group I and group II, etiology was skin ulcers and inflammation in 7 and 6, trauma in 5 and 8, scar contracture in 6 and 3 and diabetic foot in 12 and 13. Comorbidities were hypertension in 3 and 1, osteomyelitis in 2 and 4 and diabetes mellitus in 17 and 16. Wound bed inflammation was seen in 1 and 2, partial necrosis in 3 and 2, complete necrosis in 1 and 3 and postoperative wound infection in 1 and 2 respectively. In group I, flaps used were free ALT perforator flap in 14, free AMT perforator flap in 10 and free medial plantar flap in 2 cases. In group II, antemalleolar flap in 8, dorsalis pedis flap in 5, first dorsal metatarsal artery flap in 6, medial pedis flap in 4 and sural neurocutaneous flap in 7 cases. The difference was significant (P< 0.05). Flap type and postoperative wound infection were responsible for flap survival and failure (P< 0.05). Conclusion: For lower limb reconstruction, both free and pedicled flaps seem to be good surgical techniques with comparable surgical results.Flap type and postoperative wound infection were both independent risk factors influencing the flap survival rate in the foot and ankle. Key words:Flap type, pedicled flaps, wound infection