Objective: To evaluate the efficacy of the anterolateral thigh perforator flap in repairing head and face skin defects. Methods: Nineteen patients with head and facial skin defects, admitted to the 303rd Hospital and the 89th Hospital of the People’s Liberation Army from May 2012 to May 2020, were selected as research subjects and underwent repair surgery. The primary method employed was free transplantation of the anterolateral thigh perforator flap. Following the operation, patients were closely monitored for 5 to 7 days. The viability of the blood vessels was assessed based on the healing, color, and vascular filling of the flaps. Patients were followed up for 6 to 18 months post-operation to evaluate the donor and recipient sites. Results: Out of the 19 transplanted flaps, 18 survived completely, yielding a survival rate of 94.73%. The recurrence rate of the original lesion post-operation was 10.52%. 94.44% of patients reported no impact on lower limb movement on the side where the flap was harvested, and only 16.66% of patients experienced noticeable numbness in the donor site skin after the operation. All 19 patients reported that initially, the flaps were stiff and had limited movement. However, after 6 months, they gradually softened and adhered more closely to the original skin tissue. Conclusion: The free anterolateral femoral perforator flap is an ideal option for repairing head and facial defects. It offers a reliable blood supply, a large harvestable area, and minimal impact on both donor and recipient sites. Its abundant blood supply remains unaffected by the repair surgery, resulting in a relatively high survival rate. It demonstrates good adaptability and is more readily accepted by patients.