Objective To evaluate the clinical application of immediate breast reconstruction with the pedicle transverse rectus abdominus myocutaneons(TRAM)flap.Methods Ten breast cancer patients underwent immediate breast reconstruction with the pedicle TRAM flap after mastectomy,among which 4 cases used single pediele TRAM and 6 cases used bipedical TRAM.Polypropypene mesh were applied on all cases of patients to repair the abdominal defect. Results All the breast reconstructions were successful.Complications included grafting flap infection in one case and skin necrosis on partial abdominal skin flap in one case.The reconstructed breasts had a very good shape in 8 cases,and good in 2 cases.No local recurrence and distant metastasis occurred in the patients during the follow-up time ranging from 3 to 15 months. Conclutions Immediate breast reconstruction with the pedicle TRAM flap is an ideal breast reconstruction method for those patients undergoing mastectomy not only because it reconstructs the defective breast but for its cosmetic effect on the abdominal wall.