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BACKGROUND Popliteal fossa defects are common arising from several causes. Options of reconstruction around the knee could be limited by the cause of defect or interventions. Medial genicular artery flap is known in the books but not in popular use despite its obvious advantages of superior vascularity, adequate size, suppleness, and hidden donor site. AIM To promote the use of this flap due to its advantages and ease of use especially in resource poor settings. PATIENTS AND METHODS We report two patients from a low resource setting aged