The myocutnneous pectoralis major flap has recently caught the attention of head and neck surgeons. Over the last 12 months, our irvice has used this flap in 14 patients. Reconstruction in the oral cavity and larynx as well as closure of large areas of skin necrosis of ic neck have been the indications. Our complications occurred in 4 of the 14 patients and included neck abscess and fistula, flap:crosis, and chest wall hematoma or abscess. The flap is an eminently useful and successful flap when designed and performed as in-cated in the body of the paper.