The radial forearm flap is a reconstructive method for addressing complex tissue defects, owing to its ability to provide a thin, pliable tissue covering, stable vascular anatomy, and a long vascular pedicle. In cases of soft tissue and bone defects, vascularized tissue coverage facilitates functional recovery. The radial forearm flap may be utilized as either a free or pedicled flap and can be designed as a composite flap to include various tissues. Preoperative planning and rigorous evaluation of the patient`s vascular anatomy are essential components for successful radial forearm flap application. The surgical technique requires meticulous flap design and a comprehensive process to minimize potential complications. Key advantages of the radial forearm flap include superior tissue compatibility, technical ease, and a robust capacity for tissue provision. However, radial artery sacrifice and cosmetic considerations at the donor site present notable limitations. Despite advancements in microsurgical methods, the radial forearm flap remains one of the preferred option for the reconstruction of hand and upper extremity defects and stands out as a reliable option for the reconstruction of large and complex defects.