In cases of closure of myelomeningocele  defects, soft tissue coverage  is needed as soon as the dural closure has been achieved. Small myelomeningocele  defects can be managed by undermining ofthe surrounding skin but in the cases of large thoracolumbar  or lumbosacral defects local flaps (skin or muscle flaps) are widely used. Purpose: To compare between two surgical techniques in repair of large myelomeningocele defects with muscle flaps and skin flaps in the different aspects and to provide a durable, protective, and tension-free soft tissue covering. Methods: We presented a review of our 3-year experience using this approach for closure of  myelomeningocele.  Our  study  included  10  consecutive  patients  treated  using  reversed latissimus dorsi muscle flap (group A) and other 10 cases treated with skin flaps (group B) for reconstruction of the myelomeningocele  defects. Results:  In all patients operated on a tension free closure was obtained. Complications developed in cases covered with skin flaps were one hematoma, one subclinical infection and 3 wound dehiscence while there was only one case that developed hematoma after coverage with reversed latissimus dorsi flaps. There was no patient with late breakdown ofthe wound during 2 years of mean follow-up. Conclusion: Instead of less donor site morbidity the skin flaps have higher operative complication  rate  (dehiscence,   hematoma   and  subclinical  infection)   than  with  reversed latissimus dorsi flaps, so we can conclude that reversed latissimus dorsi flaps are still preferred to skinflaps  in closure of large myelomeningeocele  defects.