Introduction and aim of the work: In the last 20 years, microvascular free tissue transfer has been established, worldwide, as the method of choice in reconstructing oral and oropharyngeal defects. In this study we present our experience in using microvascular free flaps in oral and oropharyngeal cavity and outline the different flaps used. This is to evaluate the success and complications rates and the functional outcome. 
Material and methods: This is a prospective study, included patients who had underwent immediate free tissue transfer for reconstruction of defects following resection of locally advanced oral and oropharyngeal cancer and treated at Sohag 
University and Kasr El-Ainy Hospitals, in the period from March 2002 to October 2003. The following data had been 
registered: surgical procedure; type of flap used for reconstruction; success rate; and local complications. Functional outcome was evaluated 6 months postoperatively. 
Results: A total of 19 patients with age range from 35-72 years were included in this study. Free flaps used for reconstruction included: 13 free radial forearm flap; 2 free latismus dorsi flap; 3 free fibula flap; and 1 vascularised iliac crest flap. Flaps were successful in 17 cases , one totally lost and one was partially lost. 2 cases developed Orocutaneous fistula, 2 cases developed wound sepsis and wound dehiscence occurred in one case. Functional outcome assessment revealed good or acceptable results in most of the domains used for evaluation. 
Conclusions: These findings suggested that microvascular free tissue transfer is the optimum method of reconstructing major defects after extirpation of locally advanced oral cancer. Apart from providing a good bulk of tissues for closure of the defect, but also, helps in minimising the complications of such major surgery, and improving the functional and aesthetic outcome.