OBJECTIVE To investigate the clinical effect of the pectoralis major myocutaneous flap and Ti-plate system in repairing mandibular defects caused by resection of oral carcinoma. METHODS From November 2001 to February 2003, 32 patients with mandibular defect caused by resection of oral carcinoma were treated. Combined radical neck dissection with resection of gingival and mandible was performed on 11 patients with carcinoma of the lower gingival, combined radical neck dissection with glossectomy and mandibulectomy on 13 patients with carcinoma of tongue, combined radical neck dissection with resection of floor of mouth and mandible on 4 patients with carcinoma of floor of mouth, and combined radical neck dissection with resection of cheek and mandible on 4 patients with carcinoma of buccal mucosa, respectively. The defects of mandible were associated with soft-tissue component, the sizes of defect ranged from 5.5 cm x 7.6 cm to 8. 2 cm x 10.5 cm. The defects were reconstructed with 6 cm x 7 cm to 9 cm x 10 cm pectoralis major myocutaneous flaps and Ti-plate system. The effect was studied retrospectively. RESULTS Thirty-two cases were followed for 2-19 months; 29 cases of flaps survived and 3 cases of flaps partly necrosed (10% or less of the skin paddle). The appearance of face was satisfactory in 27 patients, and slight deformity of face was observed in 5 patients. The occluding relation and masticatory function were recovered well. Opening mouth extents ranged from 2.7 cm to 3.4 cm. No temporomandibular arthrosis relating to operation was found in all cases. CONCLUSION A combination of the pectoralis major myocutaneous flap and Ti-plate system is an ideal method for reconstruction of mandible defects associated with soft-tissue component after radical operation of oral carcinoma.