The rectus abdominis free flap is a versatile tool that is well suited to a variety of reconstructive problems in the head and neck, including defects of the orbit, the tongue, the cheek, the posterior mandible, and the neck. This flap, which has a high success rate, can be harvested while the ablative team is still excising the tumor. The donor site morbidity is minimal, and the time required to complete the surgery is less than that for most other free flaps. For these reasons, the rectus abdominis free flap has become an increasingly popular tool for use in head and neck reconstruction.