Autologous breast reconstruction involves recreation of the breast mound following mastectomy using a patient’s own tissue. Benefits of autologous reconstruction include the creation of an aesthetically pleasing and naturally feeling breast while avoiding implant-related complications, including capsular contracture, prosthetic infection, and implant rupture. There are a number of different flaps and techniques, which have been described, and often the use of a particular donor site is dependent on the patient’s body habitus and preferences. This chapter will discuss the most commonly used flaps in autologous breast reconstruction, including the pedicled TRAM flap, pedicled latissimus dorsi flap, deep inferior epigastric artery perforator flap (DIEP), superior gluteal artery perforator flap (SGAP), profunda artery perforator flap (PAP), and lumbar artery perforator flaps (LAP).