Background and Objective: Currently, modified radical mastectomy with reconstruction via abdominal flaps is considered as an accepted common surgical technique in the treatment of locally advanced breast cancer. However, the information about the rate of complications and its success in previous studies has many contradictions. Therefore, this study was conducted with the aim of investigating the rate of complications, recurrence and survival of patients with localized breast cancer and reconstruction with the abdominal flap method. Materials & Methods: In this retrospective cohort study, patients with locally advanced breast cancer who were treated at Shahada Tajrish Hospital in Tehran between 2011 and 2012 by modified radical mastectomy along with breast reconstruction by abdominal flap were included. Initially, according to inclusion criteria, patients with the invasive ductal carcinoma histopathology, treated by one surgeon, advanced stage of the disease, and the absence of distant metastasis were selected. Then, patients satisfaction, the incidence of complications, and recurrence and survival rates were recorded during three-monthly visits for 48 months followed-up. Results: In the present study, the mean age of the patients was 55.7 years (with a standard deviation of 11.2 years), and mean satisfaction from a VAS score equal to 7.5 in the first 6 months to a score of 10 at the end of one year. Also, local recurrence was not seen in any of the patients. However, at the end of 48 months of follow-up, 32 patients were alive, which indicates a survival rate of 88%. Conclusion: The results indicated high patient satisfaction, low rate of surgical complications, no local recurrence, and a promising survival rate.