We raised thenar island flaps that were supplied by perforators that originated in the superficial palmar arch or the superficial palmar branch of the radial artery for the reconstruction of fingertip defects in eight patients. The flap was so well-vascularised that a large flap with increased mobility could be raised. The donor site was covered with well-vascularised thick tissue, and skin grafting of the donor site was avoided in all cases. No patient developed a complication, and all flaps survived. Functional and cosmetic results of both fingertips and donor sites were excellent. A perforator island flap from the thenar eminence can be raised easily without injuring any digital and palmar arteries. They have a good colour and texture that matches the fingertips and donor site defects on the palm.