Simultaneous scalp and skull reconstruction using free muscle flap transfer and titanium mesh was performed in two patients with postoperative intracranial infection. The postoperative course in both patients was uneventful. The transferred flap was the latissimus dorsi muscle flap in one and a combination flap with the latissimus dorsi and serratus anterior muscle in another. The titanium mesh afforded satisfactory contour with only mild foreign-body reaction and could be applied simultaneously with the free muscle flap to the infected cranial wound.