Soft tissue coverage of the leg and knee defects can be difficult, as they often expose bone, tendon or joints. The diverse method including free flap, local random pattern skin flap, jump flap or cross leg flap may be used, but it is thought to be that they have some limitation and disadvantage on their application. A useful alternative to these methods is the skin grafted muscle flap. Popularized by Ger (1966)10), this technique is generally simple, safe and reliable. This report is based on the experience of 49 patients who were treated by muscle transposition due to pretibial soft tissue defect in Kyungpook National University, from 1980 to 1991. 1. The cause of lesion were 25 cases of open fracture, 18 cases of chronic osteomyelitis, 2 cases of chronic ulcer, 2 cases of burn scar contracture and 2 cases of malignant skin tumor. 2. The medial head of gastrocnemius was transposed in 11 cases of knee or proximal 1/3 lesion, soleus was used in 21 cases of middle 1/3 lesion and 3 cases of distal 1/3 lesion. Tibialis anterior and flexor hallucis longus were used in 6 cases of middle & distal 1/3 lesion. 3. Primary skin graft was done in 34 cases, delayed in 15 cases. 4. Among 49 cases, 44 cases were healed successfully within 3 weeks but reoperation was needed in 5 cases.