Objective:The aim of the study was to present our experience in reconstruction of complex defects of the nose. Methods:Fourteen patients presenting with large composite defects of the nose were anatomical y reconstructed after ful tumor clearance of a skin cancer. The aesthetic outcome was assessed subjectively and objectively while the functional outcome was only assessed subjectively in 13 patients. Results:Basal cel carcinoma (BCC), represented the tumor excised in 10 patients while the remaining 4 patients suf ered from squamous cel carcinoma (SCC). One patient died of extensive local recurrence of SCC after 6 months. The commonest flap used for inner lining was the septal flap while the forehead paramedian flap provided the external coverage for the majority of patients. Al flaps survived completely except in one patient who developed distal paramedian forehead flap necrosis. Two patients developed multiple abscesses and sinuses discharg-ing parts of cartilage grafts through the flaps’ skin with one patient suf ering from total extrusion of the costal cartilage grafts. Two other patients suf ered from severe nostril stenosis. Al patients had variable degree of dif iculty in airway passage, while most patients were satisfied with the total nasal appearance. The objective assessment of the overal appearance of the nose scored less than the subjective satisfaction. Conclusion:Reconstruction of complex nasal defects has a high learning curve. Intranasal flaps are usual y of limited size and nostril asymmetry is likely to occur. Local or regional skin flaps if available are stil considered a good choice for inner as wel as outer lining.