The greater omental reconstruction for body parts defect has been applied since 1963. The first breast reconstruction with omentum alone after mastectomy was reported in 1979. Laparoscopic harvest of omental flap (LHOF) has two blood supplement forms—pedicled or freed—for nearby chest region or distal defects, respectively. The omental flap is supplied by the right gastroepiploic vessel, originating from the communicating system between celiac and superior mesenteric arteries. Traditional multi ports or single incision methods are both feasible. The first incision of the greater omentum can be started from the insertion site of transverse colon. Then the dissection continues to the splenic flexure of colon. After full take-down of the splenic flexure, the direction of dissection turns to the greater curvature side of stomach after meticulous ligating of the left gastroepiploic vessels and its perforators. After fully dissection of the greater omentum until the pylorus region, the right gastroepiploic vessels can be fully exposed. The greater omental flap then be elevated to the surface of right lobe of liver for further extraction. A subcutaneous tunned in made from the mammary defect until the subxiphoid point. Then the tunnel is turned downward into the peritoneal space. The flap can be retrieved across this tunnel into the mammary defect site. Although the long-term oncological outcome is not durable for immediate reconstruction with omental flap after mastectomy, it is still a convenient and low complication rate method without foreign tissue reaction.