Objective To compare the clinical effect of sural neurovascular flap with the lateral or reverse medial flap to repair the skin defects of leg,ankle and foot. Methods Thirty patients were divided into two groups.The defect area was 3 cm×6 cm to 30 cm×15 cm .In 15 cases used sural neurovascular flap (group A) was used and in the other 15 cases lateral or reverse medial flap of leg (group B) was used. All patients received direct suturing or skin graft for closure. Results All patients were followed up for 3 to 6 months. Patients in group A had not any complications; the flap texture, appearance and function were satisfactory; the largest repair area was 30 cm×15 cm.In group B, 5 cases had distal 1/3 necrosis and wound healing after skin grafting; the largest repair area was 18 cm×30 cm. 3 cases' skin graft survival was poor, and 5 cases had high dorsal foot flap tension and scar. Conclusions In the foot and ankle wound repair operation, both the sural nerve nutrient artery island flap and the lateral or reverse medial flap of leg can be chosen. The sural nerve nutrient artery island flap has a better effect .