Free flaps in head and neck reconstruction offer a one step reconstructive procedure with a decreased patient morbidity and an 85% successrate in 60 free flaps, including twenty-eight intra-oral free flaps. Groinflaps were used in twenty-five patients and latissimus dorsi flaps in 34 patients. The indications included benign conditions in 10 patients, from which six has an atrofia of subcutaneous fattissue in the face. Carcinomas were treated in 50 patients. Forty squamous cell carcinomas involved 11 tumors of the floor of the mouth and 11 tongue carcinomas, five orbita and four nose reconstructions. The facial artery was the recipient vessel in 70% of the extra-oral and 68% of the intra-oral free flaps. The lingual artery was used in 12% of the cases, and the superior thyroid artery in 10% of the cases. Free flap procedures, do not increase the operation time substantially. The wound healing is excellent and the hospital stay shortened to 10 days. This quick recovery improves the quality of life for patients with often extensive cancer. Also major salvage procedure can be carried out after conventional methods have failed.