Objective To investigate the repairing methods and experience of special elderly patients after resection of giant tumors of the scalp defect in large area. Methods The presented study includes 26 patients, 22 cases with chronic pulmonary heart disease or metabolic diseases, with poor general condition, 4 patients with malignancy. After fully excising tumors, the area of the defect ranged from 9 cm×18 cm～16 cm×24 cm, 26 cases were repaired with the skin grafts, axial flaps, expanded flaps and free flaps depending on the wound characteristics. Results 5 cases were performed skin graft, 2 cases of small skin graft necrosis, after radiotherapy 3 cases skin graft necrosis in the following-up, wound closure with skin grafts.3 cases were performed free flaps, 2 cases of partial edge necrosis, 1 case of most necrosis, skin grafts to repair wounds.5 cases were performed expanded flaps, 3 cases of wide incision scar, all complained about the process of treatment was too long, the process of expansion of the stent produced discomfort. 13 cases were performed axial flaps, 1 case of distal flap necrosis, 1 flap incision dehiscence, skin flap did not necrosis after radiotherapy. All cases were followed up for 6 months to 2 years, 1 case of tumor recurrence, 1 case dead for advanced lung cancer. Conclusions For the special elderly patients with comorbidities or malignancy, it is better that large scalp defect after giant tumor resection repaired with axial flap, because surgical scar is not obvious, flaps were satisfactory appearance and function, the treatment time is relatively short, be prepared for treatment of complications or cancer and won valuable time.