Background: Coverage of traumatic soft-tissue defects in the lower limb is a common procedure. Objectives: The purpose of this prospective case series study was explore the capacity of the perforator-based sural flap in reconstruction surgery of patients with high velocity gunshot wounds in the distal third of the leg and heel pad of the foot. Patients and Methods: A prospective case series study was undertaken to assess the sural fasciocutaneous flap carried out in our hospital, from 2010 to 2011. This case series study comprised eight patients, seven men and one woman with an average age of 35 years (19-55) and with a mean follow-up duration of 13 months (6-24 months). All patients had a history of a gunshot wound in distal part of the leg and heel pad of the foot with large soft-tissue defects; treatment was done using the reverse sural flap.. Results: We performed reverse sural flaps in eight gunshot patients, to cover the defects of the lower leg and foot. Surgical site infection observed in one patient (12.5%) was treated successfully with antibiotic therapy. The reverse sural flap provided a satisfactory coverage for gunshot defects in all the patients. Conclusions: Reverse sural flap is a useful and versatile reconstructive method in patients with gunshot wounds of the lower leg and foot.