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Objective To explore the clinical effect of radial collateral artery perforator flap in repairing the exposed wound of deep tissue behind elbow.Methods From April 2016 to December 2018,28 patients with posterior elbow skin and soft tissue defect with exposed bone and tendon were treated in our hospital.the radial collateral artery perforator flap was used to repair the wound.There were 19 cases of skin defect with ulna exposure after electric shock injury,5 cases of hot compression injury and 4 cases of bone exposure caused by skin contusion after traffic accident.Results There is no complication after the operation,all the flaps were survived.The flaps had good quality and satisfactory recovery of appearance and function.Conclusion The lateral upper arm flap designed by perforating branch of radial collateral artery is an effective method for posterior elbow skin and soft tissue defect because of its constant anatomic position and long vascular pedicle.