Abstract Background: The supraclavicular artery island flap (SCAIF) has been used successfully for head and neck recon-structive purpose especially in oral tumor ablative surgery, providing acceptable outcomes. Aim of Study: To assess morbidity of shoulder after harvesting of SCAIF applied for reconstruction of oral defects after cancer surgery. Patients and Methods: Prospective analytical descriptive case series study including 33 patients with tumors involving oral mucosa diagnosed and managed by wider local excision of tumor, neck dissection (ND) and immediate reconstruction of the resultant defects with pedicled SCAIF. The follow-up was at least 6 months after surgery. Donor site postoperative complications and late morbidity were assessed. Results: Our study included 33 patients (17 males and 16 females); their mean age was 54.3. Postoperative donor site complications occurred in six patients (18.2%); three major complications managed surgically and three minor complica-tions managed conservatively. Our results of donor site com-plication can be classified according to Clavien-Dindo system as two for grade II; three for grade IIIa, and one for grade IIIb. Late morbidity included Referred sensation and shoulder pain which occurred in 21.2% and 15.2%. Arm movement was nearly normal in most of cases (93.9%), it was affected in only 2 cases only. Conclusions: SCAIF is a safe technically simple thin pliable fascio cutaneous regional flap. It should be considered as a reliable option for reconstruction of oral defect after cancer surgery. Donor site complications after SCAIF harvest-ing are minimal with little insignificant effect on arm movement and shoulder function.