The reconstruction of extensive traumatic lower limb defects need free flaps for covering the defects when no local flaps are available for covering the defects. Free ALT flap is one of the most commonly used flaps for reconstruction of extensive lower limb defects. This is a prospective study of the thirty seven patients who had undergone Free ALT flap cover for the extensive traumatic lower limb wound defects between January 2018 to April 2021 at our Trauma care Hospital. One hundred and thirty patients had undergone reconstruction of traumatic lower limb with one of the flap surgery. Thirty seven of this patients had underwent a free ALT flap surgery for limb reconstruction. Only traumatic lower limb wound defects were included in the study. Nontraumatic wounds like diabetic limb wounds or cancer wound defects were excluded. All the patient data including (age, sex and comorbidities), mode of injury (Road traffic accident, Fall of heavy object, Crush injury), wound defect data (site, size, underlying fracture and exposed structures), presence of any vascular injury in the limb, the microvascular flap data, postoperative complications and management data, follow up data were recorded. Among patients who were managed with ALT flap, 62.6% of patients presented with Post traumatic raw area, 25% of patients presented with Heel pad avulsion, 6.2% of patients presented with Post fasciotomy wound and 6.2% of patients presented with Ankle contracture. Among patients who were managed with ALT flap, the success rate was found to be 81.2%, 9.4% of patients had partial flap necrosis and 9.4% of patients had complete flap necrosis.