<p>Oral cavity malignancies causing full thickness cheek defects constitute a special group which require meticulous reconstruction post resection in resource limited settings where free flaps are not routinely feasible. We aimed to study the post operative outcome of patients in whom the bipaddled pectoralis major myocutaneous flap was used to reconstruct through and through defects.of the oral cavity. This is a retrospective study in which we analysed data of patients undergoing bipaddled pectoralis major myocutaneous flap reconstruction for full thickness cheek defects in our institute during the period from April 2022 to April 2024. A total of 44 patients with T4a disease underwent bipaddled PMMC flap reconstruction during the two year period. Women constituted 72.7% ( 32 patients ) ; median age of the group was 56 years.The subsite of primary disease was buccal mucosa in 28 patients ( 63.6% ) and lower gingivobuccal sulcus in 16 patients( 36.4% ). The average operating time was 190 min. Post operatively, minor wound complications such as wound infection occurred in 7 patients (15%). Partial dehiscence occurred in 6 (13%) patients, managed by debridement and secondary suturing, whereas flap loss leading to orocutaneous fistula occurred in 3 patients ( 9%) necessitating a second procedure for cover. 90% of patients had satisfactory oral competence post procedure. One patient had troublesome drooling.Satisfactory oral intake was achieved by the 2nd to 3rd post operative week in over 70% of patients. The bipaddled pectoralis major myocutaneous flap is a worthy option in full thickness oral cavity defects in resource constrained settings in terms of technical feasibility, time conservation and success rates .</p>