Objective To introduce the surgical procedure and indication of the dorsoulnar arterial retrograde flap of the thumb in repair of soft tissue defect. Methods From March 2000 to March 2001, 12 cases of soft tissue defect with exposed bone at the distal thumb were involved. Ten flaps were pedicled distally at the proximal rotation point, 25 cm proximal to the cuticule. Two flaps were pedicled distally at the distal rotation point, 1.0 cm proximal to the cuticule. The flaps harvested in this study were 1.1 cm×1.3 cm to 1.8 cm×2.5 cm.Results All the flaps survived. After an follow-up of 2 to 14 months postoperatively, the appearance of the thumbs were satisfactory, except those of 2 thumbs repaired by the flaps transferred at the distal rotation point, which were bulkiness because of theuncovered pedicle. In 6 cases, the defect of finger pulp was repaired, and the 2point discrimination was measured 810 mm. The same range of motion of the thumb IP joint were observed in both sides in all cases.Conclusion The optimal indication of the procedure is soft tissue defect at the distal thumb.