The iliac crest free flap based on the deep circumflex iliac artery and vein was first described by both Taylor et al. and Sanders and Mayou et al. in 1979. The ascending branch of the deep circumflex iliac artery is the blood supply to the internal oblique muscle. The flap can be harvested with the entire internal oblique muscle or a small portion, as well as skin to provide additional soft tissue coverage. This flap has relatively consistent anatomy and is ideal for both mandible reconstruction as well as midface reconstruction. The cancellous and cortical bone are ideal for dental rehabilitation. However, the main drawback of using this flap is the risk for hernia and postoperative pain.