Objective: We aim to look at the epidemiology of lower limb trauma and study the post-operative functional outcome. Study Design: Descriptive study Sett ing: Burns and Plastic Surgery Center, Hayatabad Medical Complex, Peshawar Duration: six years Material and Methods: After approval from the ethical board, data was collected from hospital records. Data regarding patient demographics, site, anatomic location of injury, and type of reconstructive procedure done was collected. Complications including partial (significant or insignificant) or complete necrosis was documented. Toronto extremity Salvage (TESS) score was calculated. Results: A total of 73 patients underwent lower limb reconstruction with mean age of 28.7+12.5 SD. Road traffic accidents (RTA) were the main cause of lower limb trauma (45.2%). There were 54.8% defects with associated fractures, most commonly tibia. The mean duration of presentation for reconstruction was 5.3 week +10.23SD. Total of 81 flaps were performed (68 pedicled and 13 free micro-vascular flaps). 35-patients required bony stabilization. Infection (8.2%) was the most common complication. Partial Flap necrosis was observed in 4(5.5%) cases, out of which 3(4.1%) were significant partial necrosis. Mean Toronto Extremity Salvage Score (TESS) was 84.8+13.6 SD. Discussion: Mostly younger male population are involved with lower limb trauma. Most patients had delayed presentation due to under developed infra-structure in the tribal areas and issues with timely referral from peripheral health care facilities. Most of the small and medium defects can be closed with local flaps. However large defects with bone involvement required free microvascular flaps. Post-operative outcome was good using TESS score. Conclusion: Robust referral system and single stage orthoplastic procedures should be adopted. Multi-center studies need to be conducted and liaison with orthopedic department is paramount to improve outcomes. [ABSTRACT FROM AUTHOR]