We are aimed to observe the effect of applying the combined temporo-occipital fascial flap in the medium scalp defect with bone exposure. Three cases of moderate scalp defect with bone exposure were admitted by The 89th Hospital of PLA and China-Japan Friendship Hospital from October 2009 to March 2014, and the wounds were repaired by application of the temporo-occipital fascial flap with medium-thickness skin grafting. And then these 3 patients were followed up after the operation, and the wound repair was observed. These 3 cases of fascial flaps all survived well with good appearance and covered the wound completely. Fibrosarcoma of one case had a relapse 3 months after operation, and the other two cases were followed up from 6 months to 3 years. Meanwhile, the appearance and function were satisfactory. The communicating branches between superficial temporal artery and occipital artery are rich. Therefore we designed and utilized the long temporo-occipital fascial flap containing the ipsilateral occipital superficial fascia to repair the scalp defect with bone exposure, and the curative effect is satisfactory.