A perforator-based medial arm propeller flap was planned from the medial arm region near the medial elbow soft tissue defect as an alternative flap. The flap was elevated and rotated by 180˚ to the defect based on the perforator. The perforator-based medial arm propeller flap should be considered as an option for reconstruction of medial elbow soft-tissue defects. The flap is easy to harvest, the operation is quick, the donor area scar is well-hidden, and the skin in this area is elastic. However, in the proximal forearm region, a flap may not be safe enough.