The anterolateral thigh flap is based on the septocutaneous perforators of the lateral circumflex femoral artery. Little has been written about anomalies of its vascular pedicle. We report two variants of the pedicle vessel in eight patients in whom this flap was used, and absence of the perforators in five other cases in whom it was attempted. The anterolateral thigh flap has the advantages of thin and pliable skin, long and large pedicle, inconspicuous donor scar and the technical possibility of combination with fascia, sensory nerve and iliac bone. If the perforators are absent, a tensor fasciae latae musculocutaneous flap or anteromedial thigh flap is available with only minor changes of the flap outline.