Abstract: Objective　To investigate the anatomical basis and clinical efficacy of the anterior malleolar perforator flaps, so as to provide a supplementary choice for repairing the soft tissue defects of ankle and foot.　Methods　15 cases of foot and ankle defects were repaired to use the anterior malleolar perforator flaps, which were designed based on the anatomical study of the anterior malleolar perforator flaps, the size and shape of the wound defects. The size of the flaps ranged from 4.0 cm×3.5 cm to 15.0 cm×6.0 cm.　Results　All the flaps survived successfully except for 1 case which appeared necrosis at the distal edge of flap and healed after dressing change. After a follow-up of 3 to 24 months, the flaps presented an excellent appearance and color and the donor sites healed without any ulcer, meanwhile, the function of weight-bearing walking was good.　Conclusions 　Four types of perforator flaps or a perforating extended flap could be designed based on the anterior malleolar perforating vessels which were constant and reliable in blood supply．The anterior malleolar perforator flaps might become a desirable choice for the repair of soft tissue defects in ankle and foot.