The authors reported a case of extensive maxillary osteoradionecrosis. The maxilla was resected and reconstructed with fibula musculocutaneous flap. It was the first reported that the osteoradionecrotic maxilla was reconstructed with free vascularized bone. The musculocutaneous flap might be a better choice of maxillary osteoradionecrosis reconstruction instead of the simple soft-tissue flap.