The segmented-fibula osteoseptocutaneous flap has been used to repair the bone and soft tissue defects of the forearm. During the operation, the fibula is divided subperiosteally at proper site according to the bony defects. The two segments of the fibula were then inserted to the radial and ulnar defects before vascular anastomosis is performed. Experience shows that anastomosis of only one group of vessels can ensure survival of both the segmented fibula and the cutaneous flap. Care should be taken to protect the muscle cuff and periosteum of the fibula, which is the source of blood supply to one segment. Four patients with bone and soft tissue defects of the forearm have been treated using this method. All the flaps survived with good function. The success of this technique contributes to the application of the free fibular flap in repair of forearm injury or osteomyelitis.