A series of nine microsurgical free flap reconstructions to amputation stumps of the upper and lower extremity was reviewed. Indications included: preservation of length after trauma (n=6), cure of local infection (n=2), and soft tissue reconstruction after tumor resection (n=1). Microvascular free flaps used were 4 scapular flaps, 2 fillet flaps from amputated extremities, 1 anterolateral thigh flap, and 1 lateral arm flap. Seven of nine patients were fitted with prostheses and underwent occupational therapy resulting in functional status. Microvascular reconstruction is indicated in emergency settings as well as for elective reconstruction of amputation sites. Using uninjured “spare parts” of the amputated extremity should be considered. Elective reconstruction is preferably performed with free flaps based on the subscapular vascular system.