Our aim was to explore the anatomical features of the cutaneous perforators from the ulnar palmar digital artery of the little finger and to establish the anatomical basis of the ulnar palmar digital artery perforator flap for reconstruction of the ulnar aspect of the palm and fingers. We found that at least one perforator is present between the metacarpophalangeal (MCP) joint and 9 mm proximal to the MCP joint. This finding establishes the anatomical basis of the distal base ulnar palmar digital artery perforator flap for reconstruction of the ulnar aspect of the palm and fingers.