Recently, the Department of Plastic and Reconstructive Surgery at our hospital successfully helped a male patient repair his entire perineal genital soft tissue defect. In mid-January 2011, Mr. Zhang (pseudonym) was admitted to our plastic surgery department from the emergency room. Mr. Zhang was admitted to our hospital in mid-January 2011 as an emergency patient. Mr. Zhang had a soft tissue defect of the male perineal genitalia caused by a car accident 2 weeks ago, and had undergone initial treatment in a primary hospital. On admission, we saw that the patient had a large area of perineal genital skin and soft tissue loss, ranging from most of the scrotum, the penis from the penile region below the coronal sulcus to the perineal region at the level of the pubic symphysis and the left perineal region between the scrotum and anus. The traumatic surface was poorly cleaned with obvious yellowish discharge, while the patient was missing the left testicle. Faced with such a large area of perineal soft tissue defect, especially with scrotal soft tissue defect, it was difficult to solve the problem by implantation alone. For this reason, under the chairmanship of Prof. Yan Ling, all the plastic surgeons discussed in detail and formulated a rigorous and well-designed surgical plan. The patient’s trauma was cleaned and changed first to solve the problem of poor trauma cleanliness. After the trauma was cleaned, bilateral inguinal flap transfer was used to repair the scrotum and posterior scrotum trauma to guarantee a thicker tissue coverage in the scrotum area, thus safeguarding the function; the penile and subpubic trauma was repaired with medium-thickness skin flap transfer. After the surgical plan was formulated, active trauma dressing changes and preoperative preparations were completed. After the wound surface was cleaned, “perineal wound debridement + bilateral inguinal flap transfer repair + skin grafting” was performed under combined lumbar and rigid anesthesia. After the operation, the flap had good blood supply and 100% of the skin pieces were viable. Thus, the patient’s extensive perineal skin and soft tissue defect was repaired. In this case, Professor Yan Ling, Director of Plastic and Reconstructive Surgery, concluded that for patients with perineal skin and soft tissue defects, there are several options for repair, but the specific situation should be decided according to the actual situation. Since the scrotum has the function of relieving external forces and regulating testicular temperature, flap transfer repair is preferred for skin soft tissue defects occurring in the scrotum, which is in line with the plastic surgery principle of “function first and aesthetics at the same time”. For soft tissue skin defects in the perineum, skin flap repair is preferred. This is in accordance with the plastic surgery principle of “simplicity: the best way to solve the problem”. In addition, the inguinal flap is a better donor area for perineal plastic surgery. The flap is thin, soft, with a constant vascular position, a large vascular caliber, a concealed donor area, and easy to close. The flap is used in a series of plastic surgery procedures such as male scrotal defect repair and female vaginal reconstruction. Plastic surgeons and urologists who are interested in the related fields will benefit from having a good knowledge of this flap.