Repair of scalp defects using local hair bearing scalp is technically challenging. Transposition or rotation of local flaps to close the defect has its own disadvantages. Reconstruction of a large posterior scalp defect using occipital artery based pedicled V-Y advancement flap following the excision of a recurrent fibrolipoma of epicranial aponeurosis is reported here. It is possible to reconstruct the defect with hair bearing scalp in a single stage along with primary closure of the donor site using this technique.