18 patients with the advanced oropharyngeal cancer from October 1983 to July 1992 were retrospectively studied in our hospital. The blood supply of the pectoralis major myocutaneous flap (PMMF). PMMF came mainly from the pectoral branch of the acromiothoracic artery. The flap area ranged from 15 cm x 10 cm to 3 cm x 3 cm. 3 cases had partial necrosis and 4 cases received prophylactic tracheotomy. The cosmetic and functional restoration was satisfactory in most of the patients. The factors which affected the wound healing were also discussed. The 3 year and 5 year survival rates were 61.5% and 40%, respectively. This paper revealed that the PMMF was the first choice for the defect of the pharyngectomy.