This study reviews our experience with free microvascular tissue transfer for the repair of midfacial defects in surgical oncology. From 2000 to 2008, eight patients with maxillectomy defects were immediately reconstructed using free flaps. Their clinical charts were retrospectively reviewed to record demographic data, ablative and reconstructive procedures, complications and outcome. Free tissue transfer was successful in all patients, giving an overall success rate of 100%. The mean follow-up time was 4 to 101 months (mr: 43.8). Three patients died from the disease giving a patient mortality of 30%, while five patients are alive, free of disease and back to their normal daily activities. The restoration of function and improvement of patients' quality of life was a common feature in all our reconstructions. The development of free tissue transfer has made surgical treatment of oncological patients with maxillectomy defects previously considered inoperable possible, improving at the same time their quality of life.