Objective To present a method for breast reconstruction with the superficial inferior epigastric artery (S1EA) flap and to summarize the operative experiences. Methods The diameter and distribution were evaluated with multipledetector-row computed tomography (MDCT) angiography and doppler perfusion flowmeter. Bipedicle superficial inferior epigastric artery flap was designed below umbilicus. Superficial inferior epigastric artery and vein were anastomosed to the internal mammary artery and vein. Results Since 2007, we have used the superficial inferior epigastric artery flap in 4 cases of breast reconstruction. Four flaps survived completely. With the follow-up of 6-12 months, the reconstructed breasts were well-shaped and there were no complications such as abdominal hernia, bulge and weakness in donor sites. Conclusions Breast reconstruction using the superficial inferior epigastric artery flaps can not only preserve the advantages of the traditional method using the deep inferior epigastric perforator flaps, but also retain the maximal function of the fascia and the rectus abdominal muscle and prevent the occurrence of abdominal weakness and hernia. It is an ideal alternative method of breast reconstruction on condition that definitive preoperative assessment of vessels and skilled surgical technique are provided.