Objective: Oncologic surgery and trauma lead to important defects in head and neck, as well as functional and cosmetic morbidities.The objective of this study was to assess the experience and outcomes of patients undergoing reconstruction with free flaps at a department of Oral and Maxillofacial Surgery in northwest China.Methods: The clinical data over a 3.5-year period (August 2010-Mar 2014) from Lanzhou general hospital was audited retrospectively.Defect causes, Flap options, operative complications, success of flaps, and speech and swallowing outcomes in patients with head and neck cancer who had been reconstructed with free tissue flap.