Background: The horseshoe-shaped mandible is difficult to reconstruct morphologically, and when a mandibular defect is large, graft of sufficient volume is hazardous. Although developments in micro vascular techniques and implantology have improved reconstructive surgery of the mandible to a great extent, the reconstruction of major mandibular defects, particularly of the curved anterior part, continues to pose a great challenge, and reconstructive procedures in most cases have a high rate of morbidity besides its effect on the mandible functionally and aesthetically. In this study, we will assess the extent of excision, effect of different reconstructive modalities, post operative complication rate and the effect of post-operative radiation on restoration of normal function of the mandible. Patients and methods: this study was conducted on 60 patients, they were divided according to the site of their defect into two groups; central and lateral. Reconstruction was done with titanium reconstructive plates and either vascularized or non vascularized bone graft according to the diagnosis. We used intraoral Glasgow scale score to assess the effect of different reconstructive modalities on the functional and aesthetic outcome of the mandible. Results: The overall complication rate was 18 patients (29.88%) in lateral group and 10 patients (16.66%) in central group. The most common complication was parathesia and plate exposure, No hard ware failure occurred. Conclusion: the size of the defect, mode of reconstruction and post operative irradiation can affect the functional and aesthetic outcome