Wound healing, as well as surgical and prosthetic aspects of the residual limb, was investigated in the below-the-knee amputation using the side-to-side flap technique. Of 23 patients, 74% achieved primary wound healing. The stump length ranged from 27% to 70% of the normal limb, and the mean percentage was 56%. The group with long stumps did not show increased risk of wound complication. All the patients had a nonbulbous dome-shaped stump that posed no prosthetic difficulty. This technique allows the longest possible limb to be preserved, and expenditure of the least amount of energy in ambulation.