Actinic brachial plexus lesions after mastectomy have been treated in 67 cases. Thirty-nine cases have been operated on, 31 of which by means of a free microvascular transfer of the greater omentum. Indications and contraindications of the procedure are discussed, as well as the types of anatomic-pathologic lesions that have been found, and the surgical technique that has been modified and improved over time is presented. Results indicate that free microvascular greater omentum transfer following neurolysis is currently the best method for relief of pain.