Pedicled tongue flaps have proved to be an effective method of repairing defects due to tissue loss in the oral cavity. Their central position, mobility, and excellent blood supply make their use feasible in a variety of sites. This paper describes the use and applications of central island tongue flaps to reconstruct defects of anterior floor of the mouth. This procedure was conducted at the Department of Oral and Maxillofacial Surgery, Medical University Hanover, introducing an improved surgical method and presenting the actual operation performed in our department. This method is considered superior for resurfacing the anterior floor of mouth defects because it is easy to perform and results in recovery of function and cosmetics.