BACKGROUND Fingertip injuries remain as one of the most common injuries in the hand. The ideal reconstruction for such injuries is to provide abundant tissue with similar qualities, preserve the length, maintain joint motion and restore fingertip sensation. Although many reconstructive methods are described in the literature, many disadvantages can be associated with these procedures. METHODS An island skin on the side of the proximal phalanx, based on the ipsilateral digital artery, was elevated to resurface the defect of the fingertip. Six male patients with fingertip injuries were treated by using this flap from August 1993 to January 1994. Their ages ranged from 20 to 55 years. The average follow-up time was 8.5 months. RESULTS Three of the six flaps were involved the middle fingers; two, for the index fingers and one, for the small finger. The sizes of the flaps varied from 1.5 by 2.0 to 2 by 3;. all the flaps survived. There was no vascular disturbance nor neurological deficit, and no limitation of joint motion. All the patients were pleased with the results. CONCLUSIONS The advantages of the reverse digital artery island flap include using a single operative field on the injured digit, allowing for treatment of single or multiple fingertip injuries, providing abundant tissue with similar qualities and aesthetic improvement.