Background: Oral cancer is currently a major global health issue. In developing countries, oral cavity cancer is estimated to be the third most common malignancy after cancer of the cervix and stomach. Surgical excision plays a major role in the treatment of oral cavity cancer patients. Objective: The aim of the study was to compare between pedicled and free flaps used for oral cavity reconstruction after ablation of squamous cell carcinoma. Patients and methods: This is a prospective comparative study that included 41 patients at National Cancer Institute (NCI) of Cairo University and Aswan University Hospital in the period from 2015 to 2018. Patients were selected from those who were attending the Outpatient Clinic of Head and Neck Surgery Unit at NCI, Cairo University and Aswan University Hospital. Results: Detection of short-term functional outcome regarding the swallowing, speech and oral competence, Contralateral Submental Island Flap (CSMIF) followed by Radial Forearm Free Flap (RFFF) showed better functional results than other flaps. The cosmetic outcome was better in 50% of CSMIF & RFFF cases. The Thoracodorsal Artery Perforator Flap (TDAPF) cases showed a slightly higher care costs than other cases although in other specialized centers the care costs were found to be higher in RFFF cases than others. Conclusion: Oncologic outcomes were better with CSMIF and cosmetic outcomes were better in CSMIF and RFFF cases. Relatively, TDAP flap cases were higher than others in the overall care costs.