The melolabial (nasolabial) flap can be designed as either a transposition or interpolated flap. Typically, this is a random pattern cutaneous island flap with its vascularity dependent on the subdermal plexus and perforators primarily from the facial artery and infraorbital artery. Alternatively, the melolabial flap can be harvested as an axial pattern flap based on branches of the facial artery. The flap has a low failure rate and favorable aesthetic outcomes. It is commonly used for nasal reconstruction but has also been employed for other head and neck defects with locations within reach.