Breast reconstruction using autologous flaps is currently the gold standard in breast reconstructive plastic surgery. Anterior abdominal wall flaps yield the most natural aesthetic result due to the similar textures of the tissues of the anterior abdominal wall and breast. When choosing this type of breast reconstruction, one should take into account a number of factors, such as age, body mass index, comorbidities, the anatomical features of blood supply to the donor and recipient zones, a history of operations on the anterior abdominal wall, cicatricial deformity of the anterior abdominal wall. The number of postoperative complications is larger in patients having risk factors (smoking, diabetes, obesity). Studies aimed at reducing the incidence of complications from autologous breast reconstruction are now in progress to reduce the rehabilitation period and to establish the most optimal timing for autologous reconstruction in patients with breast cancer during combined/combination treatment. This paper focuses on the impact of adjuvant radiotherapy on autologous breast reconstruction. An analysis of literature sources demonstrated the comparable rates of complications and reoperations in the groups of patients who had received and had not received adjuvant radiation therapy.