We describe a lateral intercostal artery perforator-based pedicled reverse thoraco-abdominal flap for coverage of the antecubital fossa after burn scar release. In this study we describe raising and insetting the flap and reported our clinical results and observations. Antecubital contracture release was carried out in six patients, and the lateral intercostal artery perforator-based pedicled reverse thoraco-abdominal flap was raised based on the anterolateral cutaneous perforator of the appropriate intercostal artery. The defects were repaired with this flap. All the flaps survived and antecubital contractures were repaired successfully. No recurrent contracture occurred in any of the patients at a mean of 15.3 months. The lateral intercostal artery perforator-based pedicled reverse thoraco-abdominal flap can be used effectively for repair of antecubital tissue defects as an alternative to other reconstructive methods.