Purpose of review The head and neck reconstructive surgeon is intimately familiar with the anterolateral thigh, radial forearm, and parascapular flaps. This review serves to describe the major abdominal-based free tissue transfers in head and neck reconstruction that can be used as alternatives to these traditional workhorse flaps. Recent findings Abdominal-based free flaps, while not traditionally used in head and neck reconstruction, are great alternatives or second-line flaps. For example, the deep circumflex iliac artery flap is an excellent alternative to the fibular free flap due to its bone height and greater overall quality of life. Summary This review article serves to review the major abdominal-based free tissue transfers in head and neck reconstruction in order to expand the toolbox of the head and neck surgeon.
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