Anatomical and clinical studies on the reverse flow axial island flap in the mastoid region were reported. The studies in the dissection of 9 cadavers with a total of 17 sides and the observations in 6 operations proved that the blood in the superfacial temporal artery could flow reversely into the postauricular artery through the anastomotic branches to nourish the mastoid island flap. So the island flap wit a fascia pedicle containing the superficial temporal vessels could be transferred to various region of the face through subcutaneous tunnel to repair deformities of the orbit, nose, eyes and cheek in one stage operation. This reverse axial island flap has been utilized in 18 cases. 16 flaps survived. All cases were followed up for 2 to 7 years. The results were satisfactory.