The radial forearm flap is ideal for intra-oral reconstruction, offering thin, pliable predominantly hairless skin to replace oral mucosa. The vascularity of the area allows considerable variation in the design of this fasciocutaneous flap and offers the possibility of including bone as an osteocutaneous flap. Furthermore, the vascular anatomy of the flap simplifies the technical aspects of free tissue transfer. Based on ten clinical cases the design of the flap is described and its versatility in differing clinical situations is illustrated. The advantages of this method of intra-oral reconstruction are discussed and evaluated.