Introduction: The reconstruction of extensive defects of the upper limb are challenging regarding both coverage and function. Latissimus dorsi is a suitably located muscle for resurfacing defects in the arm, elbow and forearm especially with exposure of the vital structures. It is a large flap, with a long pedicle and can be used as a muscle or musculocutaneous flap. Aim of the Work: Evaluate the role of pedicled latissimus dorsi flap in reconstruction of complex posttraumatic arm defects. Patients and Methods: Pedicled Latissimus dorsi flaps with split thickness skin graft were used to reconstruct 20 arm defects. The study were performed in two plastic surgery units in Egypt and Kuwait. Overall flap survival and postoperative complications were used as outcome measures. Results: None of our flap was totally necrosed. Two cases (10%) developed partial necrosis and partial graft loss occurred in 2 cases (10%). Donor site seroma formation was seen in 4 cases (20%). Four cases developed stretching of the scar. Followup ranged from (6-24 months), in which Latissimus dorsi healed perfectly, atrophied and contoured well with a cosmetically satisfactory result. No functional deficit developed from the loss of the latissimus dorsi. Conclusion: Pedicled latissimus dorsi flap is reliable, versatile, and could be the primary choice for reconstruction of post traumatic large complex arm defects.