Five cases of soft tissue defect of the lower leg were reconstructed successfully with the distally based medial adipofascial flap which was harvested with endoscopically-assisted surgery. The size of these flaps ranged from 4.0 x 7.0 cm to 5.0 x 15.0 cm in size. All the flaps had good perfusion and uneventful course postoperatively. The donor site skin was intact except for an additional access-scar 2.5 cm in length. The donor site morbidity of the adipofascial flap was further minimised in this series.