For the past decade the deltopectoral flap has become the premier reconstructive tool in oncologic head and neck surgery. It has achieved a level of reliability that has not been approached by any other single flap. Its most common application has been replacement of lost skin either from planned surgical resection or necrosis following ablative surgery. This paper illustrates a few unusual clinical settings in which the deltopectoral flap was used instead of other conventional methods: 1. Use of the same delopectoral flap in two different locations. 2. Employment of the base of the deltopectoral tube for skin coverage. 3. Successful application of bilateral simultaneous deltopectoral flaps. 4. Three-stage reconstruction of the cervical esophagus in a tenuous metabolic setting. 5. Two-stage technique for soft palate replacement. 6. An alteration of the design of the conventional deltopectoral flap because of an upper pectoral abscess.