Soft tissue defects of the little finger especially for flexor injuries located on area ll, secondary to traumatic loss or contracture of soft tissue, infection or tumor, are challenging procedures for any hand surgeon. The reconstructive goal is to provide stable coverage to all noble structures exposed. Reconstructive options for this particular area include local, regional and free flaps, but all of them offer an important donor site morbidity. We present tree clinical cases of soft tissue defects of the little finger using the hipothenar fasciocutaneous reversed island flap, designed from the skin located over the abductor digiti minimi, which is on the basis of ulnar palmar digital artery. The donor site was closed primary. Clinical results were satisfactory and donor site wound healing was adequate.