Objective: To assess the application value of the free-style anterolateral thigh perforator flap (ALTPF) based on preoperative hand-held Doppler (HHD) probe for perforator location in headandneck reconstruction.Methods: 34 patients who suffered from malignant oral and maxillofacial tumor underwent simultaneous reconstruction using free-style ALTPFs after radical resection in Xiangya Hospital from August 2013 to June 2011.Perforators of the ALTPF region were marked through HHD probe preoperatively.The skin paddle was precisely designed centered on the perforators according to soft tissue defect, and minimal-invasive incision was restricted to the flap border with no additional or extensive incisions adopted during the flap preparation.Perforators were exposed above the fascia lata femoris and then dissected retrogradely through the vastus lateralis muscle to harvest a vascular pedicle with desired caliber and length.Flap thinning was allowed if necessary.Survival rate of flap transplantation, oral aesthetics and functions as well as donor-site damage was assessed after operation.