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Introduction: Soft tissue defects with exposed Achilles tendon is common in trauma. Surgically covering these defects by fasciocutaneous flap can preserve normal function of the Achilles tendon. Various methods have been described and reported in the literatures: local advancement flap, region flap, or free flap. The purpose of this article is to report the results of 10 cases who were operated to cover the Achilles tendon by perforator V-Y advancement flap, discuss the indications and advantages of using this flap. Patients and methods: A retrospective study describes 10 cases: 8 males and 2 females, aged from 4 to 71. The patients had soft tissue defect with expose Achilles tendon who were operated cover by V-Y advancement flap based on perforator of peroneal artery from 07/2018 to 05/2021. Follow-up time from 3 months to 3 years. Results: The size of defect is from 3x2 cm to 8x6 cm. The size of flap is from 3,5x4cm to 16x6 cm. All 10/10 flaps were total survival and completely cover the defect. All patients preserved normal function of the Achilles tendon. Conclusions: Using the V-Y advancement flap based on perforator of peroneal artery to cover the soft tissue defect with expose Achilles tendon had good results, restore normal function with good aesthetic. Keywords: V-Y advancement flap, Island perforator flap, Achille tendon coverage, Exposed Achille tendon.

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