Although reconstruction of the anterior skull base has been usually done with a pericranial flap, the necessity of bone grafting has been discussed. The bone grafting are divided into two types, free bone grafting and peduculated bone grafting. The free bone grafting often induces bone resorption, resulting in higher rate of the infection. In contrast, the peduculated bone grafting has an advantage to maintain viability of bone graft, resulting in lesser risk of flapnecrosis and infection. In this paper, we propose a new method of skull base reconstruction with vascularized frontal outer table flap, which can achieve reliable closure of the skull base defect.