Restoration of oral cavity and pharyngeal function following ablative surgery remains an elusive goal. Conventional reconstructive methods often achieve satisfactory wound healing, but the introduction of a dynamic anesthetic and bulky flaps into the oral cavity can interfere with the function of the residual soft tissues. This article examines the anatomy, harvest technique, and applicability of neurosensory radial forearm flaps to head and neck reconstruction with special attention to the attributes of this donor site which, at present, make the radial forearm flap the flap of choice for the reconstruction of a variety of oral cavity and pharyngeal defects.