BACKGROUND Resections of oromandibular squamous cell carcinoma involving anterior mandible, floor of the mouth, and the skin, lead to composite oromandibular defects that can be approached in several ways depending on the extension of the bone defect, of the soft tissue and cutaneous resection, the patient's general status, and the prognosis. METHODS A retrospective evaluation of 27 patients has been performed. The techniques described included single osseous or soft tissues free flap reconstruction, two free flaps or free and locoregional flap association. RESULTS Postoperative follow-up ranged from 12 to 120 months. Final results were evaluated with regards to deglutition, speech, oral competence, and esthetic outcome. CONCLUSION Reconstruction of the anterior mandible is strongly indicated whenever possible. When the defect involves the tongue, the best results are provided by the association of two free flaps. Finally, the association of free and locoregional flaps ia a good option for external coverage reconstruction.