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The objective of this study was to evaluate the outcomes of using the free fibula flap in the reconstruction of maxillary defects.Thirty-four consecutive cases of maxillary reconstruction with the free fibula flap were reviewed. All clinical data were analyzed, including primary diseases, types of maxillary defect, free fibula flap design, perioperative complications, and follow-up results. The main postoperative functional indices, including oral diet, speech, type of dental restoration, and aesthetic results, were evaluated.Of the 34 patients who underwent maxillary reconstruction with the free fibula flap, the primary diseases were malignant tumor in 20 patients, benign tumor in 11 patients, and trauma in three patients. Free fibula flap transfer was successful in all cases. Postoperative complications occurred in five patients. Recipient-site wound infection occurred in two patients and donor-site wound dehiscence occurred in three patients. One patient with donor-site wound dehiscence had postoperative lameness. The oral and nasal cavities were separated well by the flap in all patients. The patients were able to take food orally and had no problems with speech intelligibility. Osseointegrated implants were placed in four patients, and complete conventional prostheses were applied in 19 patients. Excellent cosmetic results were obtained in 22 patients.Alveolar arch defects can be reconstructed successfully using free fibula flaps. This procedure also allows for dental implant rehabilitation, which can improve the patient’s appearance and oral function and enhance the overall quality of life. The fibula free flap transfer has a high success rate and low perioperative complication rate, making it an ideal choice for maxillary defect reconstruction.