Purpose: Simultaneous composite free tissue transfer can provide a one stage total reconstruction, including both wound resurfacing, and functional restoration. Materials and Methods: Several modifications of free tissue harvesting based on the lateral circumflex femoral artery system were performed with the aim to afford a one stage reconstruction at the acute or subacute stage. A series of 38 patients underwent (1) functioning rectus femoris MC flap, (2) functioning rectus femoris MC with accompanying anterolateral thigh flap, (3) anteroalteral thigh flap/ vastus lateralis MC flap with accompanying vascularized fascia lata, (4) Tensor fascia lata MC flap, (5) anterolateral thigh MC flap with accompanying tensor fascia lata, (6) functioning rectus femoris MC flap and tensor fascia lata-iliac crest (7) tensor facial lata or vastus lateralis MC flap with iliac crest for composite defects of 14 patellar tendons, 11Achilles tendons, and 8 anterolateral/ lateral compartment defects, 2 extensor hallucis longus,2 lower leg anterolateral/lateral compartment, and 1 calcaneus.. Results: Four re-explorations were encountered which resulted in one failure. 7 (18.4%) patients sustained postoperative wound infections and one of them underwent a below knee amputation. One patient suffered from femoral and tibial repeated chronic osteomyelitis, thus he underwent an above knee amputation. 36 patients (94.4%) can achieve either static or dynamic function after the primary one stage reconstructions. Conclusion: Regarding to lower limb reconstruction, lateral circumflex femoral artery system has several advantages: (1) one donor site involved, (2) plural facility for composite and functional reconstruction, (3) one stage functional reconstruction, (4) less major procedure in secondary reconstruction.