Surgical extirpation of malignant tumors in the head and neck always result in a defect that needs to be reconstructed to achieve proper form and function. Pedicled flaps were introduced early in the last decade and despite the progress in surgical techniques, still they constitute an important option due to their advantages and low cost compared to other measures. In this retrospective study we are reviewing 100 cases of different malignant tumors of the head and neck where pedicled flaps were used for reconstruction, revising different literature regarding the vascular anatomy, technique of harvesting, indications, advantages and disadvantages of each muscle used.