Abstract: Objective To investigate the effects of L-arginine on the microcirculation and survival of rat island skin flaps after ischemia-reperfusion. Method A right lower abdominal island flap was created in SD rats and the microcirculatory blood flow in these flaps measured with laser Doppler velocimetry following L-arginine injection via the contralateral femoral artery.Both NO and malondialdehyde (MDA) levels in the flaps were assayed and the survival of the flaps replanted in situ was evaluated 1 week later. Results L-arginine treatment caused increase in the microcirculatory blood flow of the flaps and elevation of NO while and decrease of MDA levels.The survival rate of the flaps with L-arginine treatment was significantly higher than the flaps from saline-treated and normal rats. Conclusion L-arginine can improve the survival of island flap through increasing the microcirculatory blood flow and lessening ischemia-reperfusion injury of the flaps.