AbstractScalp reconstruction after oncologic resection can be challenging. Wide surgical resections, in combination with co‐morbid conditions such as infected alloplastic material, cerebrospinal fluid (CSF) leak, or devascularized bone after craniotomy necessitate healthy, vascularized tissues for reconstruction. Although primary closure is feasible in some cases, the mainstay of treatment involves local tissue rearrangement with or without split thickness skin grafting. In addition, free tissue transfer is an important adjunct to therapy in patients with poor local tissues. Careful analysis of the defect and local tissues can help tailor the method of reconstruction and result in satisfactory closure in a majority of patients. Current techniques used for scalp reconstruction after surgical ablation are the subject of this review. J. Surg. Oncol. 2006;94:504–508. © 2006 Wiley‐Liss, Inc.