The distally based dorsal hand flap on the recurrent cutaneous branch was dissected as a reverse flap based on the connection between the dorsal branch of the proper digital artery and the terminal branches of the dorsal metacarpal artery at the level of the proximal phalanx. The reverse dorsal metacarpal artery flap dissected by this new approach was applied in five cases for coverage of some areas in the fingers. Two flaps were raised on the second and three on the third intermetacarpal space. All flaps survived completely. The donor areas were closed by direct approximation.