Purpose Epithelioid sarcoma is an exceedingly rare yet aggressive presentation that primarily affects young individuals. Surgical reconstruction of the resulting defect requires careful planning to ensure optimal outcomes for wound healing, continence, sexual function and quality of life. Case A 28-year-old woman presented with a rapidly enlarging mass in the mons pubis and peri-vulvar region. Initially suspected to be an abscess of infection, the mass did not respond to conservative management, prompting further investigation. Histopathological analysis revealed a rare cutaneous epithelioid sarcoma, involving the mons pubis, left labia majora, right labia majora, and a portion of the anterior abdominal wall. Results The patient underwent extensive surgical resection, which included excision of the entire mons pubis, left labia majora, intervening skin extending to the left groin crease and part of the right labia majora. A portion of the anterior rectus sheath was also excised and primarily closed. Given the complexity and size of the defects, a novel reconstructive approach was employed. A pedicled chimeric anterolateral thigh-vastus lateralis flap, comprising both fasciocutaneous and muscle components, was used for reconstruction. The fasciocutaneous component reconstructed the mons pubis, while the vastus lateralis muscle restored the left labia majora and peri-vulvar skin. A sheet split-thickness skin graft was applied over the muscle flap. The right labial defect was repaired using a labial advancement flap. Conclusion This case underscores the rarity of epithelioid sarcoma in the mons pubis region and highlights an innovative reconstructive technique for managing complex defects involving multiple anatomical subunits.