The aim of the present clinical study was to evaluate the feasibility of free osseocutaneous radial forearm flap in the reconstruction of full-thickness cheek defect after ablative cancer surgery.A retrospective review of data was obtained from consecutive patients requiring free osseocutaneous radial forearm flap to recover both the cutaneous and bone deficit in major full-thickness cheek defect after oncologic resection.Two patients had advanced cheek squamous cell carcinoma. All patients had combined bone and extensive soft-tissue defects. The free osseocutaneous radial forearm flap measuring 10 × 8 cm to 14 × 10 cm was used to reconstruct the major through-and-through cheek defects. No major complications occurred in any patient. The patients were followed up for 6 to 20 months; 1 patient was living with no evidence of disease, and 1 had died of local recurrence.The free osseocutaneous radial forearm flap to reconstruct major through-and-through cheek soft tissue and bone defects is reliable and an excellent alternative to other options for patients who have full-thickness defect of cheek.