Objective To investigate the enhancement of the transverse rectusabdominis musculocutaneous (TRAM) flap survival in local ischemic area by recombinant adenovirus mediated vascular endothelial growth factor 165 gene(Ad-VEGF-165). Methods The vascular pedicle TRAM flaps were made in the right abdomin of30 SD rats and they were randomly divided into 5 groups. The Ad-VEGF-165 was injected into the subcutaneous tissue of epigastra(group 1), the subcutaneous tissue of epigastria and rectus abdominis muscle (group 2), and the rectus abdominis muscle(group 3); Adenovirus mediated green fluorescent protein(Ad-GFP) and DMEMwere injected into the subcutaneous tissue of epigastria and rectus abdominis muscle as autocontrol(group 4) and blank control(group 5), respectively. The survival areas of TRAM flap was measured after 7 days of operation. The microvascular density(MVD) and the integral optical density (IOD) were tested with anti-rat CD34 and with VEGF immunohistochemistry and insitu hybridization histochemistry (ISHH), respectively. Results The survivalareas of TRAM flap in groups 1, 2 and 3 (14.19±2.77, 15.18±2.18 and 8.30±1.28 cm2) were higher than those in groups 4 and 5(4.12±186 and 3.60±1.95 cm2), being significant differences(Plt;0.05).The CD34 MVD of the TRAMflap in groups 1, 2 and 3 was higher than that in groups 4 and 5; the positiveexpression for VEGF and ISHH were shown in groups 1, 2 and 3 and there was significant difference when compared with groups 4 and 5 (Plt;0.05). Conclusion Treatment by recombinant Ad-VEGF165gene is an effective option for enhancement of the TRAM flap survival in the local ischemic area.