The V-Y advancement flap has been widely used for the reconstruction of cutaneous defects. However, direct closure is impossible without undue tension. To overcome this limitation, the present study introduces a modified design of V-Y advancement flap with two horns and assesses its clinical outcome for facial reconstruction. From June, 2009 through June, 2010, twelve cases of skin tumors were surgically excised and reconstructed with this modified V-Y flap. Defects were located in nasolabial, nasojugal fold, cheek and lower eyelid region. Modified V-Y advancement flap was designed with lateral limbs like horns of V-flap and two horns were extended to the end point of the defect. Design and movement of this flap was demonstrated with photographs and the clinical outcome was described. All flaps survived with primary healing. The follow-up period ranged from 1 month to 12 months with a mean of 5.5 months. Neither short-term nor long-term postoperative complications such as flap necrosis, hematoma, infection were noted. All twelve patients were pleased with their postoperative results and no recurrence of malignant skin tumor was observed. This modified V-Y advancement flap with two horns is a safe, easy, versatile and reliable method for functional and esthetic reconstruction of facial defects.