Early and reliable closure of large meningomyelocoele defects in newborns is critical to prevent severe infectious complications and neurologic deterioration. Here, we introduce a new surgical method for the reconstruction of large horizontal meningomyelocoele defects, in which we use unilateral myocutaneous tissue based on the superior gluteal artery (SGA) as a propellar flap. This procedure permits a tension-free and durable multilayer closure of difficult, large-scale horizontal defects that cannot adequately be treated by conventional myocutaneous advancement flaps. The technique is reliable and straightforward and requires no skin grafts or relaxing incisions. The SGA-based myocutaneous propeller flap might be a promising alternative for complex meningomyelocoele reconstructions in the future.