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Eight patients underwent free tissue transfers involving groin cutaneous or osteocutaneous flaps using the superficial and deep circumflex iliac arteries and veins. Four were used for head and neck reconstruction, two for severe neck scar contractures, and two for composite skin and mandibular reconstruction. Three were used in lower extremity reconstructions, all in situations requiring bone and skin reconstruction. One was used for skin cover alone in an upper extremity reconstruction for wrist cover. One of the head and neck cases sustained vascular thrombosis requiring a second successful free flap coverage for a 12.5% failure rate. One required re-exploration with successful salvage. The average operating time was 12 hours. The anatomy and surgical techniques are discussed. The main values of the procedure are the presence of a double vascular supply of both arteries and veins for complex reconstructions, and the fact that a large area of skin and subcutaneous tissue can be procured, with a relatively inconspicuous donor site.