In management of head and neck malignancy, it is important and critical point not only to eradicate the neoplasm, but also to reconstruct the defect functionally and cosmetically well. We experienced the case of left tongue base cancer that had recurred after the treatment of chemotherapy and radiotherapy. We managed him by bilateral functional neck dissection with extended hemiglossectomy and rectus abdominis musculocutaneous flap for the reconstruction of the defect. We report with some reviews.