The surgical treatment of advanced carcinomas of head and neck area often requires extensive resections, necessitating large flaps for reconstruction. The recent description of pectoralis major myocutaneous flap by Ariyan has added a new capability in head and neck reconstructions. Pectoralis major myocutaneous flap has many advantages such as improved vascularity, bulk, long arc of rotation and one-stage reconstruction, so it is used most frequently in head and neck reconstruction. It is the purpose of this paper to present our experiences with 4 cases of pectoralis major myocutaneous island flap used in reconstruction of oral cavity defects created from extensive resection of squamous cell carcinomas.