Oral cavity reconstruction is challenging due to complex of anatomy and function. A tongue flap is frequently used for oral cavity reconstruction in median size defect (4–7 cm2). Thirty patients indicated for soft tissue reconstruction after tumor resection and residual palatal fistulae after primary palatal repair were included. Tongue flaps were used in 20 patients with successful outcome and low donor site morbidity. Ten patients with large-size oral defects were treated by temporalis muscle flaps, buccinator myomucosal flaps, and platysma myocutaneous flaps. Appropriate oral cavity reconstruction with successful outcome was achieved with improvement of the patient quality of life.