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Since the first report in the literature by Dos Santos in 1980, the scapula flap has become one of the most commonly used fascio-cutaneous free flaps. This is due to its numerous advantages and its few inconvenients. Because of the constant anatomy, the minor donor site defect and its good aesthetic result, the scapula flap replaced other more traditional flaps such as the radial forearm or the latissimus dorsi flap. Being a flap of the "subscapular artery system", it offers the possibility to be harvested "en bloc" with the other flaps of this system for complex reconstruction procedures. In our opinion, the scapula flap is the treatment of choice to treat cutaneous defects of the lower extremity which could not be covered by local flaps. In head-neck reconstruction, the colour and texture of the skin offered by this flap is superior to other free flaps. A thick, well visible horizontal scar in the donor site is the only real inconvenience of the scapula flap. It seems that the parascapula-flap (Nassif et al. 1982) which offers the same properties as the scapula flap is on the way to replace the scapula flap in the future. After a six-year experience with this flap we will present a current concept review and our own experience based on 30 cases. Moreover, we would like to report on some technical refinements.