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Introduction: Breast cancer is a devastating disease affecting women of all ages worldwide with the age incidence in Egypt being one decade younger than the mean age incidence, the latissimus dorsi (LD) flap is an important volume-replacement option due to its stability and versatility as an autologous flap. LD flap could be used for total breast reconstruction after mastectomy in selective cases or to fill a large quadrantectomy defect. Aim: The aim of this study is to estimate the oncologic and aesthetic outcomes and the procedure-related complications of latissimus dorsi (LD) flap with skin sparing mastectomy in management of breast cancer. Patients: On 25 patients breast cancer underwent skin-sparing mastectomy with immediate reconstruction using LD flap. Methods: All patients were subjected to: (Complete history taken, General examination, Local examination and routine investigations) Surgical procedures: 25 patients with breast cancer underwent skin-sparing mastectomy with immediate reconstruction with LD flap. Results: Mean age of included patients was 41.12 years with mean BMI 29.17 kg/m², regarding tumor classification DCIS represented 8% LCIS represented 20% IDC represented 32% ILC represented 40% of all patients, Positive lymph node 1-3 in 40% of patients and more than 3 in 20% of patients and 40% of patients had negative lymph node, 96% of patients had no recurrence on the other hand only 4% shows locoregoinal recurrence, Regarding postoperative immediate complications 72% of patients showed no complications. Discussion: In the current study we aimed to estimate the oncologic and aesthetic outcomes and the procedure-related complications of latissimus dorsi (LD) flap with skin sparing mastectomy in management of breast cancer. Conclusion: Skin sparing mastectomy with immediate breast reconstruction using latissimus dorsi muscular flap allows single-stage, totally autologous reconstruction with a satisfactory aesthetic result, low morbidity, and good quality of life. Recommendations: Breast cancer patients are best managed by a multidisciplinary team, Breast conservation surgery does often leave a significant deformity which can best be corrected by an immediate LD flap reconstruction, this method is simple and effective, our concept should be further analyzed in larger comparative studies. [ABSTRACT FROM AUTHOR]