BACKGROUND Transposition flaps are frequently used to repair defects of the head and neck after tumor extirpation with Mohs micrographic surgery. OBJECTIVE To review the basic principles underlying single-stage transposition flaps and also their utility relative to location on the head and neck. MATERIALS AND METHODS A review of the literature on transposition flaps was performed with specific reference to the principles of single-stage transposition flaps, including rhomboid flaps and their variations, multilobed flaps, and the locations where transposition flaps are frequently executed on the head and neck. RESULTS Numerous articles have been written with regard to the techniques for designing and executing transposition flaps. The primary advantages of transposition flaps include less undermining as compared to large sliding flaps and the superior ability to displace tension away from the defect and from free margins. Optimal cosmesis with these flaps can be achieved with appropriate sizing of flaps (or lobes), appropriate undermining, and meticulous suturing. CONCLUSION The versatility of transposition flaps makes them optimal for repair of defects on the head and neck and utilization of the outlined key principles and techniques aid in achieving an aesthetic result.