The serratus anterior muscle has the potential of being used alone, with skin, or with skin and bone for transposition or for transplantation. Its use either inside or outside of the chest is essentially limited only the skill and experience of the surgeon. The serratus anterior muscle is a robust and reliable muscle unit. It is relatively easily dissected and has a dependable blood supply with a consistent axis of rotation. Experience suggests that this particular muscle is as reliable as other more frequently used muscles of the chest wall and is particularly useful for transposition to an intrathoracic position for life-threatening situations.