Seventeen patients, 4 of whom had osteoradionecrosis, underwent mandibular reconstruction with a revascularized scapular osteocutaneous flap. The mean length of revascularized scapular bone used was 10.4 cm. Nine of the 17 flaps healed uneventfully; however, previously irradiated patients had a higher incidence of postoperative complications. There was only 1 flap failure. We found the free revascularized scapular osteocutaneous flap to be reliable and ideal for the reconstruction of large composite defects of the oral cavity.