Abstract: Objective To study the application of lateral thoracodorsal vessels as recipient vessels in free flap breast reconstruction. Methods Ten breast cancer patients with negative sentinel lymph node biopsy underwent mastectomy with immediate free flap breast reconstruction using lateral thoracic vessels as recipient vessels in our department from January 2008 to March 2010. The operation time, flap ischemic time, complications, and cosmetic outcome were assessed. Results The operation time was 5.3-6.5(mean 5.9) h. The flap ischemic time was 55-100(mean 75) min. No severe complication occurred except partial fat necrosis in 1 patient. The patients were followed up for 4-14(mean 8.9) months with a satisfaction rate of 90% and no significant dysfunction. Conclusion Lateral thoracic vessels can be used in immediate breast reconstruction as an alternative option for thoracodorsal vessels, and especially suitable for those who do not need complete clearance of axillary lymph nodes.