The ideal reconstructive method for a urethra[ defect should provide durable, stable coverage, a patent tube passage for voiding and ejaculation, and a natural aesthetic contour, white simultaneously minimising morbidity of both the recipient and donor sites. Since the first report of the anterolateral thigh flap in 1984, this has become one of the most commonly used flaps for the reconstruction of various soft tissue defects. In this report we present our experience with a prefabricated anterolateral thigh flap used for a full-thickness defect of the urethra. The flap was used in a 40-year-old mate patient with a defect located on the proximal penile region, including full-thickness urethra and ventral penile skin measuring 2.5 x 4 cm after delay and prefabrication. To the best of our knowledge this is the only report in the literature to date of an anterolateral thigh flap being used for a urethra defect. The authors conclude that with its evident structural and cosmetic advantages, the anterolateral thigh flap can be considered an excellent and ideal flap option for selected defects of the urethra. (C) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.