The nasolabial fold flap is widely used for defect repair after nasal tumor resection due to its reliable blood supply, texture similar to nasal skin, and concealed donor-site scar within the nasolabial fold. This paper reports a case of an 89-year-old female with basal cell carcinoma (BCC) of the left nasal alar. After extended tumor resection, a full-thickness defect of the nasal alar was formed, which was reconstructed in one stage by folding a superior-pedicled nasolabial fold island flap to restore both the external coverage and the nasal vestibular lining.