The history of skin grafting, a cornerstone of reconstructive surgery, reflects centuries of innovation and refinement in medical science. Originating in ancient India around 600 BCE, the earliest documented skin grafting techniques are attributed to Sushruta, who described nasal reconstruction using autologous skin flaps. This practice, known as the "Indian method", formed the foundation of surgical reconstruction for centuries. During the Renaissance, Italian surgeon Gaspare Tagliacozzi advanced skin grafting by introducing pedicle flaps for nasal reconstruction, highlighting the importance of vascular supply in graft viability. The 19th century marked a turning point with contributions from Karl Thiersch and Jacques-Louis Reverdin, who pioneered free skin grafting techniques, transitioning from flaps to thin split-thickness grafts. These innovations significantly broadened the scope of reconstructive surgery. In the early 20th century, advancements in antisepsis, anaesthesia, and wound management further improved graft survival rates. Later, the development of full-thickness grafts and the use of skin allografts and xenografts expanded therapeutic applications. The late 20th and early 21st centuries saw the advent of bioengineered skin substitutes and stem-cell-based therapies, enabling complex reconstructions and addressing graft limitations. This historical evolution underscores the interdisciplinary nature of skin grafting, combining surgical innovation with advancements in biology and materials science. Continued research promises further breakthroughs, particularly in regenerative medicine and personalised grafting solutions.