The midline forehead flap is a good, versatile alternative when more standard techniques cannot be used to reconstruct the eyelids, medial canthus or exenterated socket. Indications are where: (1) the recipient site has a poor blood supply; (2) standard reconstructive procedures have failed; (3) deep, as well as superficial, tissue loss is present; and (4) extensive tissue loss is present. Four patients illustrate the value and versatility of the midline forehead flap. Disadvantages also are discussed.