The treatment of soft tissue problems about the elbow should be directed toward early coverage and functional rehabilitation. The current study reviews some of the available treatment options, with emphasis on the treatment of large soft tissue defects. The role of prophylactic soft tissue coverage also is discussed. For large defects not extending more than 8 cm below the elbow and for prophylactic soft tissue coverage, the authors recommend the pedicled latissimus flap, which provides reliable coverage and a generous blood supply that promotes healing at the site of injury.