Abstract The objective of this study is to assess the reliability of pectoralis major myocutaneous (PMMC) in cases of cervicofacial defects following ablative oncological surgery. We performed a prospective analysis of patients in whom PMMC was used to reconstruct head and neck surgical defects during the period from April 2014 to September 2015. The study was carried out at plastic surgery department of Sohag University Hospital and involved 20 patients. Patients' age ranged from 47 to 78 years, 16 patients were males and 4 patients were females. PMMC was used in 14 cases of defects following cancer larynx surgery and 6 cases of defects following cancer check and mandible surgery. No failures were noted in the study; however one patient died two month post-operative due to carotid blow out as a result of over dose of radiotherapy. Despite the current emphasis in tissue replacement has shifted to microvascular free-tissue transfer, the pectoralis major myocutaneous flap is still a versatile and reliable flap with an excellent reach to cervico-facial region especially in patient with poor general condition and with limited expertise and resources required for microvascular free-tissue transfer.