One hundred muscule flap transfers performed at the Mayo Clinic from 1975 to 1978 are reviewed and assessed as to the cause and location of the defects, muscles used, complications, and results. We found the muscle flaps very versatile for covering for a wide variety of difficult soft tissue and bony defects. The complication rate was very low, considering the severity and chronic nature of the problem. Ninety-two percent of patients showed healing after surgery, and 82% remained healed at the time of this follow-up survey.