Various pedicle flaps were used for the reconstruction of large defects following extirpation of head and neck malignant tumors of 55 patients. Although there are several complications, myocutaneous (MC) island flap surpassed the deltopectoral (DP) flap in the reconstruction of the pharyngo-esophagus, tongue, oral cavity, mandible, and of a massive defect. However, DP flap is still valuable material because of its steadiness in pharyngo-esophageal reconstruction in patients who have background disorders, such as serious heart disease and diabetes. Forehead or DP flap is valuable in the reconstructive surgery of full-thickness defect of the cheek. Reconstruction of extremely large defect of the head and neck could be accomplished by use of latissimus dorsi flap and/or combination with DP flap. Selection of the flap should be made in accordance with the region of the reconstruction, size of region, sex, and individual considerations.