Original Research Article We have shared our experience with posterior interosseous flap in 12 cases, its results and versatility for defects over hand dorsal and palmar surfaces due to various etiologies. Surgical anatomy, harvesting techniques and results were discussed. The uniqueness and versatility of posterior interosseous artery flap is-sparing a major axial vessel supplying to hand and simultaneously providing tissue from the same anatomical region, ends in single stage with satisfactory outcome.