Author Affiliations 1Department of Plastic Surgery, Royal London Hospital, UK 2Department of Neurosurgery, Hull University Teaching Hospitals NHS Trust, UK Received: March 17, 2020 | Published: March 30, 2020 Corresponding author: Oliver AG Kemp, Department of Neurosurgery, Hull University Teaching Hospitals NHS Trust, UK DOI: 10.26717/BJSTR.2020.26.004406 Cancer of the hypopharynx and larynx, in spite of advancements in chemoradiotherapy, remains a deadly disease, particularly in developing nations. This is often attributed to it being detected late in the disease progression; and while neoadjuvant chemotherapy has worked wonders in the early stages of the disease, advanced manifestations often warrant more radical surgical resection. Following a resection adequate reconstruction is required, not only to fill a defect, but also with the aim of restoring some degree of functionality to the patient’s speech and swallowing. Plastic surgeons specializing in head and neck reconstruction have utilized a wide variety of microvascular procedures to deal with laryngopharyngeal reconstruction. The main stay of treatment is the use of a range of local pedicle flaps, or free flaps from elsewhere in the body to cover the defects. Throughout this paper, the various flap choices are compared and reviewed. While it appears, there is no unequivocal superiority of one type of flap over the other, this is dependent on a number of factors. Often the outcome and choice of flap is influenced by the size of defect, prior radiotherapy, surgeon’s familiarity with the technique, patient’s preoperative morbidity, and the need to restore function. Keywords: Laryngopharyngeal; Pharyngeal; Laryngeal; Cancer; Reconstruction; Flap Abbreviations: ALT: Anterolateral Thigh Flap; LDMC: Latissimus Dorsi Myocutaneous Flap; PMMC: Pectoralis Major Myocutaneous Flap; RFFF: Radial Forearm Free Flap; SCM: Sternocleidomastoid; TDAP: Thoracodorsal Artery Perforator; TPFF: Temporoparietal Free Flap