It is well known that the gastrocnemius muscular flap is very effective in the management of soft tissue defect at the proximal leg. However, the gastrocnemius muscular flap is ineffective in the management of the soft tissue defect at middle one-third of the leg, because of it short length and small dimensions. Since McCraw described the use of the medial gastrocnemius myocutaneous flap in 1976, the medial gastrocnemius myocutaneous flap has revolutionized the management of defects in the knee and the proximal three-fourths of the leg. The authors reviewed the 7 patients treated with medial gastrocnemius myocutaneous flap for the soft tissue defect of middle one-third of the leg from March 1989 to December 1992 in Holy Family Hospital. The following results were obtained; 1. The coverage range of the medial gastrocnemius myocutaneous flap included the middle one-third of the tibia, because of its larger size and dimensions. 2. There was little or no functional deficit on knee and ankle joint, providing that the soleus and the other head of the gastrocnemius were left intact and functioning. 3. This flap could be raised easily, quickly, and safely, by decreasing the possibility of inadvertent damage to the flap's blood suppy.