Background: The reconstruction of knee defects has always been a challenge of high interest in plastic surgery. The lateral superior genicular artery flap is a reliable option. The main objective of this study was to evaluate the reliability of the lateral superior genicular perforator flap for reconstruction of the acute traumatic defects around the knee. Methods: The study was conducted in Emergency Department, Cairo University hospital, during the period from July 2012 to April 2015. We recruited patients between 19 to 59 years who needed coverage of traumatic soft tissue defect around the knee. We made the lateral superior genicular perforator flap in all cases acutely after exclusion of major life-threatening conditions. All cases have been followed up for three months for infection, hematoma, disfigurement, contracture and partial/complete flap failure. Results: Twenty cases were included in the study with a three month postoperative follow up. Age ranged between 19-59 years with average age 35.7. Eighty percent of the cases were males (16 cases) while the rest were females. The majority of cases 12 (60%) had right lower limb injury. Thirteen cases were associated with orthopedic fractures, seven with vascular injuries and two with bilateral lower limb fractures. Flap survival was seen in nineteen (95%) cases. Partial loss of the flap occurred in four (20%) cases, which showed areas of distal necrosis. The resulting raw areas that occurred were spontaneously closed by secondary intention during the follow-up period, one raw area required skin graft. Complete loss of the flap occurred only in one case (5%). Superficial epidermolysis occurred in two cases; one of them was plus infection which was treated by medical treatment and dressing. Hematoma occurred only in one case in which the flap was saved after the evacuation of hematoma. Sixteen cases had the donor site closed primarily; four of them got infected and one gapped. The other four cases required split thickness skin graft from the start. Conclusion: Finally, we conclude that for reconstruction of soft tissue defects around the knee, the lateral superior genicular perforator flap is a suitable option. It showed a high rate of flap survival with a good clinical outcome and considerable small adverse events rate. Keywords: Traumatic injury; soft tissue defects; the knee; lateral superior genicular perforator flap.