Penile reconstructive surgeries are performed mainly for congenital abnormalities of the urethra or penis, penile trauma or fracture, penile cancer, short penis and in cases of gender reassignment this work was done on ten patients who suffered from partial to total penile loss. Five of them needed total penile reconstruction (total phalloplasty). All patient were males (no transsexuals included in this study), the age varied between 3 months to 30 years with the average 20 years old. Five cases of total penile reconstruction with a sensitive forearm free flap based on the radial artery are presented. No partial or complete flap losses were found. The only complication found in all patients was a urinary fistula, which was repaired successfully with a secondary surgical procedure. The aesthetic and functional outcome was satisfactory to the patient and surgical team in all cases. A sensitive radial forearm free flap is a good choice of treatment for total penile reconstruction.