Tensor fascia latae (TFL) myocutaneous flap, utilized as a novel approach for the successful functional repair of the foot drop deformity is presented in this case report. A 21-year-old male patient was subjected to a close-range high-velocity gunshot injury and sustained comminuted Gustillo-type IIIB open fracture of his left tibia. A composite skin and soft tissue defect including tibialis anterior and extansor hallucis longus tendons was determined. The injury was managed in two stages. In the first stage, the immediate reconstruction of the open tibia fracture was provided by using a reverse flow sural flap and external fixation of the fracture. The functional restoration was achieved by vascular fascia latae in the second stage, 6 months after the initial skin, soft tissue, and bone defect repair. The functional recovery was successful, and the foot drop gait was almost totally ameliorated. Reconstruction with TFL flap should be retained in the armamentarium for the functional repair of the foot drop deformity, caused by composite skin and soft tissue defects of the pretibial region. © 2012 Wiley Periodicals, Inc. Microsurgery, 2013.