Eighty-three free flaps were used to repair head and neck cancer defects between 1993 and 1995. The flaps used were 37 (44%) radial forearm flaps, 29 (35%) iliac crest flaps, 8 (10%) free jejunum flaps, 4 (5%) fibula flaps, 3 (3%) latissimus dorsi flaps and 2 (2%) rectus abdomini flaps. The indications for each flap are discussed. The flap loss rate was 4.8%, which led to reoperation with a new free flap in 3.6% of the cases. The other complications are discussed. Pre and post operative radiotherapy had no influence on the outcome of the free flaps. The mean duration of hospitalisation was 36 days. 78% of the patients who underwent a mandibular reconstruction were fitted with a fixed dental prosthesis and had normal mastication. 66% of the patients with oropharyngeal reconstruction had normal deglutition and 30% had a mixed diet. The acceptable complication rate, the good esthetic and functional results obtained with free flaps indicate that they should be used as a first choice technique in the reconstruction of head and neck cancer defects.