The radial forearm flap is a well-vascularized fasciocutaneous free flap, transferred on the radial artery and vein. In cases of partial hypopharyngectomy, tracheo-esophageal fistulas and hypopharyngeal stenosis it may be difficult to accommodate the bulk of a myocutaneous flap without interfering with pharyngeal function. The thin, pliable nature of the forearm skin is ideally suited to replace hypopharyngeal mucosa. The result is a thin-walled pharynx.