A new anterior tibial flap has been designed. It is nourished by a single septocutaneous branch of the anterior tibial artery and its veins, running vertically through the anterior crural septum and appearing in the deep fascia of the lower half of the lower leg. This differs from the two other types of anterior tibial flap which have been reported and are nourished by different septocutaneous branches. We call our flap the anterior tibial flap type III in order to avoid confusion. We have applied it clinically in two cases as a reverse-flow island flap, anastomosing one vena comitans to a superficial vein at the edge of the wound in order to avoid venous congestion. Both flaps survived well with no problems.