The lower limbs have the specialized function of providing both mobility and weight bearing properties. Trauma and tumour is the commonest cause of defects arising in both bone and soft tissues. The problem area is usually the knee and below. This is largely because of the subcutaneous nature of the bone in certain parts of the limb. Tissues to be reconstructed include the bone, joints and soft tissues. Importantly the goal is to restore the bone and the joints for weight bearing and mobility. Soft tissue reconstruction is sourced from the local skin and muscle in general. Lower part of the leg and foot has few potential donor sites and therefore generally require the transfer of tissue from distant sites and the use of microsurgery. It is also important that the limb is pain free and the end stage of reconstruction be reached in a reasonable period of time. If at the outset if these goals cannot be achieved or the condition itself is best treated by an amputation then this needs to be seriously considered. The advantage that we enjoy in this modern age is that available prosthesis adequately makeup for loss of part of the limb. Therefore the amputee does not in reality suffer a significant disability.