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We treated chronic osteomyelitis of the tibia with musculocutaneous flap transplantation from the latisimus dorsi. The patient was a 79-year-old male. He developed osteomyelitis of his right tibia 76 years previously. Since then, he had been treated with skin flap transplantation at the age of 38 and with Papineau's method 29 years later. This time, a large skin defect was observed on the anterior aspect of his lower leg. Pseudomonas aeruginosa was detected from the pus culture. We performed curretage and irrigation for the lesion twice to lessen the activity of infection. We then transplanted latissimus dorsi musculocutaneous flap to cover the defect of lesion.