The present refresher article highlights the current role of pedicled flaps in the reconstruction of complex wounds at the lower extremity. Due to the increasing standardization and ongoing improvements in microsurgery and in view of the fact that local tissue limitation and elevated rates of wound healing disorders reduced the attraction of pedicled flaps to the lower extremity, free flaps became a serious alternative. However, in consideration of the individual patient demand pedicled flaps to the lower extremity still have their eligibility and can be superior to free flaps in selected cases. Here we present a short guide for the general use and indications of pedicled flaps particular to the lower extremity and give a detailed overview of five established pedicled flaps. Based on our experience we provide pitfalls and pearls and discuss the reconstructive decision-making in light of the alternative free flap option.