The radial forearm flap or 'Chinese' flap, originally used as a fasciocutaneous flap based on the radial artery, is extremely versatile and can be employed as free vascularized or island flap with or without skin, vascularized nerve, tendons or bone. The radial forearm flap was performed in 21 patients (16 free and 5 as a distally based island flap) for head and neck as well as for hand and foot reconstruction. All flaps survived. Indications and complications are discussed.