The management of squamous cell carcinoma of the head and neck presents a considerable aesthetic and functional problem. Recently major progress has been achieved in management of these patients. This can be attributed to the advances in preoperative evaluation of the extent of tumor using three dimensional spiral CT scan and MRI which has great impact on the pre operative planning and decision. Also the use of lymphatic mapping using visual localization and lymphoscintigraphy for localization of sentinel L.N in patients with N0 (N0 palpable L.N). The N0 disease has become both controversial of interest to most surgeons as the risk of micro metastases is about 20% which need elective treatment in form surgery or radiation at the time of treatment of the primary. Lastly but not the least the eventual outcome of these patients have been improved by major advances in reconstructive surgery including the use of local flaps, distant flaps as pectoralis major flap and free micro vascular tissue transfer flap. Local flaps whenever possible , may be an ideal solution and this is in concordance with Kalus and Zamora1996 and Sobhi 2000.Distant flaps especially musculocutaneous flaps as pectoralis major gave excellent results especially in reconstruction of complex facial defects . Free micro vascular tissue transfer is indicated in recurrent cases , aesthetic disturbance due to local flaps ,if local tissues are not available and if previous radiotherapy was given.