A new field of application of the pedicled serratus anterior muscle flap is presented. Severe axillary neuropathic pain and distress due to neuroma formation were treated by wrapping the pedicled serratus anterior muscle flap around the brachial plexus. Covering the fascicles by well vascularized muscle tissue results in significant postoperative pain relief. We describe a new method in the treatment of severe neuropathic pain syndromes originating from the brachial plexus, with good result.