Vascularized bone grafts have become the preferred method of mandibular reconstruction. However, the technique is considered to increase both the operating time and blood loss, which might be associated with an increased morbidity and mortality. We conducted a retrospective analysis of 100 consecutive patients who underwent immediate bridging plate reconstruction. The median follow-up duration was 70 months. The 5-year overall survival rate was 69.9%. Cox multivariate analysis revealed that red blood cell transfusion was an independent prognostic factor for the overall survival. The plate survival with no complications was 62.2% at 5 years. Anterolateral defects and preoperative radiotherapy emerged as an independent adverse factor for plate survival. The use of bridging plates is an option for lateral mandibular reconstruction with no preoperative irradiation to avoid the risk from blood transfusion.