Background/aim: Various flap procedures have been described and used for the lower eyelids; however, the nasolabial flap is rarely employed. We herein aimed to present the clinical results of using the superiorly based nasolabial island flap for repair of surgical defects extending to the lateral lower eyelid. Materials and methods: Nine patients with a mean age of 62 +- 6 years underwent surgery for reconstruction of the lower eyelid.Results: The diagnosis of lesions was nodular basal-cell carcinoma (n = 5), superficial basal-cell carcinoma (n = 1), well-differentiated squamous-cell carcinoma (n = 1), and basosquamous-cell carcinoma (n = 2). According to the classification reported by Spinelli and Jelks, 6 surgical defects were located at zones II and IV, while 3 were at zones II and V. Five patients required posterior lamellar reconstruction. Lagopthalmos (n = 1), ectropion (n = 1), and transient numbness of the ipsilateral upper lip (n = 1) were noted as postoperative complications. Conclusion: Despite the low number of patients, the present series demonstrated that lower eyelid defects involving zone IV or zone V can be repaired safely and reliably with the superiorly based nasolabial island flap, along with its use shown in the literature for zone II or zone III defects. The technique for raising the flap is fairly simple, with predictable surgical results. In addition, the superiorly based nasolabial island flap provides a reliable means of obtaining good wound healing with acceptable aesthetics, as well as functional results of both the donor site and reconstructed area.