BACKGROUND: Preoperative computed tomography angiography CTA of the abdominal wall vessels is used when planning free flap breast reconstruction FFBR because it provides a surgical road map which facilitates flap harvest. ...CONCLUSIONS: CTA in FFBR can have a wider impact than facilitating surgical planning and reducing operative times. Incidental findings can influence the surgical plan, and in some instances, avoid doomed to fail and unsafe surgery. ...