The trapezius myocutaneous flap is currently an ideal way to repair severe electrical injuries of the head and neck. However, the tissue level damage caused by high-voltage electrical injuries is more complex, and there are many myocutaneous flap repair procedures. Improper operation will lead to postoperative loss of appearance and function, flap infection and donor site wound dehiscence and other complications. Therefore, the correct choice of surgical technique and the effective design and application of flaps are important. The aim of the study was to show the application of modified trapezius myocutaneous flap in severe structural defects of the head and neck caused by high-voltage electric burns, so as to reduce damage to the donor site and ensure the beauty of the donor site, while rebuilding neck stability. We systematically reviewed the clinical data of 4 patients who underwent modified trapezius myocutaneous flap to repair severe electric shock injuries of the head and neck with bone exposure, summarized the surgical procedures, and displayed the surgical details in the form of pictures and videos. All modified flaps survived in 4 patients with severe deep electrical burns of the head and neck. The wounds were successfully repaired, and the appearance and function were restored satisfactorily. The appearance of the flaps was not bloated. In addition, the donor site wounds were directly pulled and sutured, and recovered smoothly with good function. The modified trapezius myocutaneous flap is valuable for the repair and reconstruction of severe electrical burn wounds of the head and neck.