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The intraoperative evaluation of flap perfusion is essential to the success of tissue transfer.1,2 Despite flap survival, hypoperfusion at the tip or along the wound edges predisposes patients for delayed wound healing, tissue necrosis and sometimes requires a second flap.3,4 As this represents a major complication, considerable efforts have been undertaken to improve intraoperative assessment of peripheral flap perfusion, which often remains a highly subjective evaluation based on the surgeon's individual experience taking into account parameters such as capillary refill, turgor, flap temperature, and bleeding from the wound edges to variable degrees.2 Objective methods like thermography, laser-assisted Doppler flow measurement, or tissue oxygenation have been proposed but have not become widely accepted in the clinical setting for numerous reasons.2 In recent years, indocyanine-green fluorescence angiography (ICG-FA) has evolved considerably making it cost-effective and simple to use in the clinical setting.2,5–7 In autologous breast reconstruction with microvascular-free flaps, ICG-FA has helped to reduce postoperative fat necrosis by allowing visualizing the extent of critically perfused areas intraoperatively which need to be resected.8–10 Only few reports utilizing ICG-FA in pedicled flaps exist.11–13 In a pedicled flap, both the amount of tissue available for transfer and inset of the flap are limited. Contrary to a microvascular deep inferior epigastric artery perforator flap, the potential for intraoperative tissue resection at the margins is significantly limited as it reduces flap reach without any means of lengthening the vascular pedicle. Adequate perfusion of the tip of the flap is crucial as it often covers the most critical aspect of the defect. Similar to microvascular perforator flaps, ICG-FA may be useful in pedicled perforator flaps to assess perfusion. The aim of the study is to retrospectively evaluate our experience with ICG-FA to determine safe flap dimensions of pedicled flaps based on a single perforator intraoperatively.