OBJECTIVE The aim of the study was to compare multislice computed tomography angiography (MSCTA) to digital subtraction angiography (DSA) for vascular mapping of the head and neck. METHODS In 50 patients who were scheduled for microvascular reconstruction of the mandible with osteomyocutaneous flaps, MSCTA was carried out before surgery. DSA served as the method of reference. Selective common carotid angiograms were acquired in 2 projections for both sides of the neck. A 64-slice spiral computed tomography (CT) was carried out with a dual-phase protocol, using the arterial phase images for 3-dimensional CTA reconstruction. Volume rendering was used to visualize MSCTA data. RESULTS No adverse reactions or complications occurred during or after the procedures. All CT angiograms were of diagnostic quality. No statistically significant differences between MSCTA and DSA were found for the detection of branches of the external carotid artery that are relevant host vessels for microsurgery neither in the group of 26 patients who had not had surgical treatment before (P = .687), nor in the group of 24 patients who were affected by either a tumor recurrence or an infected osteoradionecrosis (P = .508). CONCLUSIONS MSCTA proved to be a reliable alternative to DSA in vascular mapping for planning of microvascular reconstruction of the mandible.