Lower extremity defects show a wide clinical picture depending on the affected anatomical location, tissue amount, and tissue content. Lower extremity defects are an area where local and regional reconstruction options are limited due to reasons such as vascular anatomy and distance to other locations. Large, complex tissue defects and adjacent injuries eliminate reconstruction options with local and regional flaps (Uyar I, Aksam E, Yit K. Ulus Travma Acil Cerrahi Derg 29(8):877–882, 2023). In such cases where local and regional flaps cannot be used, microvascular surgical techniques are the ultimate reconstruction option in defect reconstruction. Recent advances in microsurgical techniques and a better understanding of the microvascular anatomy of the lower extremity allow us to personalize reconstruction options on a patient-by-patient basis and achieve reconstructive outcomes with lower donor site morbidity and higher success rates. Free tissue transplants provide optimal reconstruction, especially in challenging areas such as the lower extremity, where other reconstruction options are not suitable. Although microsurgical techniques have been extensively studied in the last 20 years and many issues have been clarified, free tissue transfer to the lower extremity for limb salvage is still challenging. Free tissue transfer is widely indicated in limb-sparing surgery for lower extremity reconstruction, but it is known to have a lower success rate than transfers to other body regions (Dotson RJ, Bishop AT, Wood MB, Schroeder A. Microsurgery 18:125–128, 1998). A comprehensive approach should be provided to achieve successful lower extremity reconstruction. A comprehensive approach includes patient selection, flap selection, recipient vessel selection, flap dissection, flap preparation, microvascular anastomosis, flap placement, immediate postoperative care, postoperative intermediate care, and follow-ups (Pu LLQ. Clin Plast Surg 48(2):201–214, 2021). This section will describe frequently used free flaps in literature that can be used in cases where local and regional reconstruction options cannot be used in lower extremity reconstruction.