When reconstructing the radionecrotic chest wall ulcer, safety of the flap is essential. If the flap becomes necrotic, fatal situations may arise, such as pyothorax, especially when prosthetic replacement is chosen. Thus, flaps with a rich and stable blood supply must be chosen for necrotic chest wall reconstruction.We present the case of a 67-year-old lady who developed radionecrosis following irradiation of the chest wall after radical mastectomy. The ensuing radionecrosis of the skin and chest wall progressed to advanced ischemia with secondary infection. The necrotic ribs and surrounding tissue were debrided and the anterior chest wall was reconstructed by pediculed omental and vertical rectus abdominis myocutaneous flap. The patient is currently well and alive without any evidence of recurrence of either infection or breast carcinoma.