The anterolateral thigh (ALT) flap is a commonly used donor site for reconstructive surger, especially in head and neck reconstructions. The flap's success is primarily determined by the quality and quantity of its perforating vessels, which is why clinicians typically prefer harvesting from a healthy leg with intact vascular anatomy. Poliomyelitis typically causes unilateral lower limb paralysis, resulting in muscle atrophy and deformities. Harvesting the ALT flap from the paralyzed leg could preserve the function of the unaffected limb, but this approach is complicated by the atrophy and deformities present in the affected leg, creating substantial challenges. We here report the successful ALT flap harvesting from the polio-affected leg in a 55-year-old male patient for the reconstruction of a tongue defect. The patient diagnosed with Left tongue squamous cell carcinoma, and underwent tongue cancer excision and a modified radical neck dissection. The flap survived and healed well with the patient's tongue tissue. The wound at the donor site on the thigh also healed well. There were no complications observed in either the flap or the donor site. Our experience suggests that harvesting from the paralyzed leg is a safe and feasible procedure that preserves the function of the unaffected limb and may enhance the postoperative quality of life for polio survivors.