Background: Reconstruction of head and neck defects is a highly challenging and complex surgical undertaken. Various technique including skin grafts, regional flaps and free tissue transfer can be employed in the restoration of function and cosmesis. however commonly used techniques, such as radial forearm free flap or anterior lateral thigh flap share numerous disadvantages ,such as donor site morbidity, poor color match for cutaneous reconstruction and excessive tissue bulk especially for intraoral reconstruction. The submental artery flap is an axial flap based on submental artery and it was first described by Martin et al in 1993. The submental island flap is the submental island flap is a valid option for reconstruction of small to moderate sized soft tissue defects of head and neck. It represents a reasonable alternative to free flaps particularly in elderly patient. The advantages of the submental flap include its minimal donor site morbidity, excellent cutaneous color, texture, thickness match. Material and method: 10 patients with orofacial defects. The aetiology of defects were due to malignancy in 7 cases, 2 post burn, 1 for coverage of reconstructive plate after segment mandibulectomy. Result: 8 patients have satisfactory function and good cosmetic result. 1 patient showed flap loss due to injury of pedicle intraoperatively. 1 patient has a donor site morbidity healed by secondary intension. Conclusion: The submental island flap is a valid option in reconstruction of small to moderate size defects of head and neck. It gives a good function and cosmetic result if the patients are properly selected.