Eight free iliac osteocutaneous flaps and three vascularized iliac bone grafts based on the deep circumflex iliac vessels were transferred in 11 cases of large skin and bone or bone defects. Seven of the eight osteocutaneous flaps took successfully. The eighth demonstrated partial necrosis. There was complete bone union in ten cases, and no union in one case as a result of persistent infection. Based on this experience, we concluded that free osteocutaneous flaps based on the deep circumflex iliac vessels have the following advantages over free osteocutaneous flaps based on the superficial circumflex iliac vessels: the pedicle is long (5 to 7 cm); the nutrient vessels are large (artery: 2.2 mm; vein: 2.5 mm); the anatomic course of the vessels is constant; and there is a large amount of bone available.