Pelvic exenteration or extensive abdominoperineal resections, in combination with radiation therapy, may result in difficulties with healing of the wound in the perineum. In addition, the reconstruction of a functional vagina is rendered difficult. At the Mayo Clinic between February 1980 and October 1981, eight patients underwent vaginal reconstruction with use of bilateral gracilis myocutaneous flaps. Although complications were experienced, the procedure resulted in healed wounds in all patients. Patient satisfaction with respect to sexual function was variable. Reconstruction of the vagina and closure of the extensive defect after pelvic exenteration by using gracilis myocutaneous flaps seems to be a worthwhile and appropriate procedure.