Objective To discuss clinical application of descending genicular artery perforator flap.Methods According to the anatomic features of direction,branches and anastomosis of the descending genicular artery,the descending genicular genicular artery perforator flap at medial superior aspect of knee joint was designed to reconstruct the soft tissue defects at the anterior medial 1/3 of the calf and the anterior medial part and popliteal fossa of the knee,with the axis based on the anterior border of the Sartorius and with the pivot point on the site where the cutaneous branches from the superior medial genicular artery pierced out within the triangle concave surface bounded by the vastus medialis,the tendon of adductor magnus and the condylus medialis.Results All flaps survived well in five patients,with primary healing.After a follow-up of 1-12 months,all flaps turned out to be with good texture,near-normal color and good appearance.Conclusion With a constant anatomic location,excellent blood supply and easy surgical procedure,the descending genicular artery perforator flap is one of feasible ways for repair of soft tissue defects around the knee.