Flap coverage in periprosthetic joint infections is a key strategy to preserve the joint and avoid amputation in extreme cases with soft tissue defects. Muscle and fasciocutaneous flaps show similar success rates in eradicating infection, provided that debridement is adequate and antibiotic treatment is optimal. In hip, shoulder, and knee joints, pedicled local flaps predominate, while in the ankle joint, due to the scarcity of tissue, free flaps are more frequent. The choice of flap depends on the size of the defect, the availability of recipient vessels, and surgical experience. Adequate coverage with flaps in this type of infection increases the success rate in saving the joint, and therefore, the function of the limb, and reduces the need for amputation, consolidating as an essential reconstructive option in this field.