Covering the elbow soft tissue defects is a difficult task for the plastic surgeon. Because of, the important anatomical structures situated superficially and the high tendency for stiffness of the elbow, the reconstructive method must be chosen carefully. Traditionally the free flaps were the choice method for elbow reconstruction. In our department, we use the perforator pedicled flaps for covering elbow defects, as a viable alternative to the free microsurgical transfer. This paper presents a successful case of covering an elbow soft tissue defect in a male patient. By using a local pedicled flap we replaced "like with like" to obtain a very good cosmetic result. The lack of microsurgical anastomosis allowed an early physical therapy.