The fibula flap was first described by Taylor et al (1975). The fibular osteoseptocutaneous flap (FOCF) was subsequently described by Chen and Yan (1983) and its anatomy was clarified by Wei et al (1986). In 1990, Flemming et al reported 7 cases of mandibular reconstruction using vascularized fibula graft. The FOCF has many advantages, which are the rich blood supply of fibula, easy accessability to donor site, relatively hairless and thin paddle of skin, a strong bone up to 22 cm and low donor site morbidity. The disadvantage is the variable blood supply to the skin paddle. The authors experienced one case of mouth floor cancer excised surgically and reconstructed using FOCF. So we reports it with the anatomic review and surgical technique.