Conclusion. Because of minimal donor region morbidity, pliability, the presence of long and large caliber vessels, and lack of visible scar, the free anterolateral thigh flap provides an ideal option for restoration of full-thickness nasal defects. Objective. Full-thickness nasal defect reconstruction requires internal nasal lining and external cover. In large defects, internal nasal lining replacement with traditional sources may not be expedient. We describe reconstruction of full-thickness nasal defects with free anterolateral thigh flap. Patients and methods. From August 2005 to July 2007, six patients with full-thickness nasal defects underwent nasal reconstruction using free anterolateral thigh flap. All defects resulted from tumor resections. Four patients had a basal cell carcinoma, one an epidermoid carcinoma, and the other patient had recurrent malignant fibrous histiocytoma. Results. All flaps survived completely. The average hospitalization time was 3 days. No complication was observed.