OBJECTIVE To analyze the results of reconstruction in terms of complications, functional restoration and cosmetic restoration of lateral cheek rotation flap. METHODS A cross sectional study was conducted between April 2004 and January 2005. Patient's particulars and history were documented. The cause, whether trauma or tumor resection, and dimensions of the defects were recorded. All the patients underwent a "cheek rotation flap" procedure to reconstruct the defect. Post-operative complications like haematoma formation, infection and flap necrosis were noted. Results were assessed in terms of functional as well as aesthetic restoration. RESULTS A total of 30 patients were included with a male to female ratio of 3:1 and an average age of 46 +/- 14.7. The majority of the defects (76%) were post tumour excision, while the rest (24%) followed trauma. The average defect diameter was 7.5 cms. There was no peri-operative mortality or total flap loss. There were three cases (10%) of transient facial nerve palsy who recovered spontaneously. The final reconstruction was deemed satisfactory in terms of functional and cosmetic restoration in the majority of cases (93%). CONCLUSIONS Our results with the lateral cheek rotation flap to reconstruct the defects involving medial cheek have prompted us to recommend it as a first line reconstructive option for many varieties of defects in this area.