Breast reconstruction using autologous tissue and muscle sparing technique has become increasingly popular. The deep inferior epigastric perforator (DIEP) free flap is one of the latest refinement in the use of abdominal soft tissue to reconstruct the breast while preserving the rectus abdominus muscles. Free flap breast reconstruction has been shown to have many advantages over conventional pedicle TRAM flap surgery, however controversy has arisen regarding the complication rates of DIEP flaps versus the use of the free TRAM flap. This study evaluates the outcomes of 170 consecutive DIEP flaps performed in 132 patients in a community setting. Thirty eight patients had bilateral procedures. Immediate reconstruction was performed in 95 cases (56%) and 75 cases (44%) were delayed reconstructions. The mean age of patients was 50 years (range, 26 to 74 years). Mean hospital stay was 3.36 days. Risk factors were present: smokers 25%, previous radiotherapy 22%, and obesity 30%. The thoracodorsal vessels were the preferred inflow for the DIEP flaps which were based on one (41%), two (28%), three (25%), four (4%), or five (0.6%) perforators. The mean postoperative follow-up period was 15.9 months (range, 3 to 34 months). Total flap necrosis occurred in 7 patients (4.1%) while partial flap loss occurred in 10 Patients (5.9%). Fat necrosis occurred in 18 patients (11.1%). No abdominal hernias were noted but 2 patients (1.1%) had slight unilateral abdominal wall bulges. All patients were able to resume their normal daily activities. One hundred sixty one patients (95%) had a mean of 1.3 secondary procedures for breast mound shaping, scar revision and/or nipple reconstruction including 36 patients (21%) who had mastopexy or reduction surgery performed to the contralateral breast for symmetry. DIEP flap reconstruction offers the advantage of reducing abdominal wall morbidity allowing short hospital stays and return to normal daily activity. These data indicate that while performing the DIEP flap may be more technically demanding, this operation can be safely carried out in a community setting with complication rates no higher than those reported for free TRAM flaps.