Abstract: ObjectiveTo investigate the efficacy and safety for breast reconstruction with pedicled flap after mastectomy. Methods From March 2004 to June 2010, 37 cases of breast reconstruction were carried out with pedicled flap, TRAM or Latissimus dorsi, of which 34 were immediate and 3 were delayed.Synthetic mesh was applied to reinforce the abdominal wall after pedicled TRAM flap in 15 patients. Results Partial flap necrosis was observed in 1 patient with TRAM；skin necrosis occurred in 6 patients with immediate reconstruction；subcutenous seroma collection at dorner site was found in 3 patients with Latissimus dorsi；fat necrosis occurred at the abdominal incision for 3 patients with TRAM；no abdominal bulge or hernia was observed.With the follow-up from 2 months to 72 months, 1 local recurrence and 1 distant recurrence were observed.The overall satisfaction rate was 94.59%. Conclusion Breast reconstruction with pedicled flap, TRAM or Latissimus dorsi, was both effective and safe, furthermore synthetic mesh applied was able to strengthen abdominal wall and avoid abdominal hernia.