Initially described by Song et al. in 1984, the anterolateral thigh free flap most commonly derives its blood supply from the descending branch of the lateral circumflex system. The artery runs between the rectus femoris and vastus lateralis muscles in the anterior compartment of the thigh and is generally accompanied by two vena comitantes. There is minimal donor site morbidity involved in flap harvest, making it an ideal donor site for amenable defects. The anterolateral thigh free flap can be harvested as a myocutaneous, fasciocutaneous, or adipofascial flap, making it extremely versatile for reconstruction of a variety of mucosal, cutaneous, and soft tissue defects involving the head and neck.