Pedicle flaps are performed within the operative dermatology basically to close larger operation defects following surgical excision of malignant skin tumors. It is a fact, that more than 3/4 of these skin tumors are located on the head and the cervical region. Especially in this area local and regional flaps guarantee a functionally and aesthetically satisfying reconstruction of the excised structures. As a matter of fact the basic methods of pedicle flaps as the transposition and the advancement-flaps are known for more than a hundred years. In the meantime the techniques were merely refined and modified, so that even extended skin and soft-tissue defects can be closed without compromising on radicality. Based on broad own experience the indication and the application of these techniques are described. Possible risks are demonstrated which can arise by disregarding anatomical and morphological conditions.