Patients with advanced head and neck cancers require reconstruction with a double free flap, but in some situations, it is extremely difficult to attain the ideal set of recipient vessels for these patients. The patients were divided into two groups: group 1 had one recipient vessel; group 2 had two recipient vessels. Fifty-five patients were enrolled between 2001 and 2005. Double flaps, including a fibula osteoseptocutaneous flap and an anterolateral thigh flap, were used for the reconstruction. In group 1, the second flap was anastomosed at the distal runoff of the fibular flap. Group 1 contained 39 patients and group 2 had 16 patients. No significant differences in the success rate, operating time, days of hospitalization, or complication rate were noted between groups 1 and 2. Thus using one recipient vessel is our first choice for double free-flap reconstruction for head and neck defects.