The surgical resection of primary and secondary tumors involving the chest wall often requires reconstruction with prosthetic and soft tissues, such as muscle flaps. There are situations when a soft tissue reconstruction of the chest wall is preferable. Prosthetic material can become infected and require reoperation for removal of the infected material. Rigid prosthetic materials can result in chest wall pain and deformity. Muscle is the soft tissue of choice for coverage of full-thickness chest wall defects with or without prosthetic material. Muscle flaps can be transferred to chest wall defects with either pedicle muscle transposition or free muscle transfer.