INTRODUCTION Scrotal defects resulting from many factors, including accidents, Fournier's gangrene, and gunshot injuries, present difficulties in management and reconstruction. Antibiotic therapy must be given to all patients, and if necessary vigorous debridement must be performed. Because of the abundant vascularity of the region, local wound dressing results in dramatically rapid recovery of the wounds. In unsuitable conditions that prevent primary closure of the scrotal skin, thigh flaps may be used. TECHNICAL Proximally based neurovascular pudendal thigh flaps were used in 10 scrotal defects. Maximum CONSIDERATIONS dimensions of elevated flaps were 20 X 15 cm. All donor areas were closed primarily. Satisfactory results were achieved in all patients, especially in terms of sensitivity. CONCLUSIONS Neurovascular pudendal thigh flaps are an excellent reconstructive choice for scrotal defects because of being sensate and having minimal donor-site morbidity.