The radial forearm free flap (RFFF) was first described by Yang et al. in 1981. Arterial supply of the flap is from the radial artery and drainage by the cephalic vein and venae comitantes. The vascular anatomy is one of the most consistent and reliable with the added benefit of a long pedicle with large caliber vessels. The RFFF is one of the pillars of head and neck soft tissue reconstruction given its thinness, reliable vascularization, and pliable tissue.