Soft tissue defects resulted from a variety of reasons not only lead to appearance disfigurement, but also seriously affect emotional well-being of patients, and is one of the most significant challenges in reconstructive and plastic surgery. Autologous fat graft has been popular in repair of soft tissue defects because of its rich material resources, convenience in obtaining, no immunity reaction and so on. But its unstability and significant resorption over time has greatly restricted its wider utilization in patients. The main problem is insufficient blood supply in fat grafts. So more and more researches focus on how to improve microvascular angiogenesis and fat graft viability. Here we review recent studies that revealed the microvascular angiogenesis in autologous fat graft.