<p>Oro-mandibular defect reconstruction is always a challenge following the excision of oral cavity malignancies. Free flaps are considered ideal for the reconstruction of postexcision defects. Alternatively, regional flaps, like Nasolabial flaps, can be used as a workhorse for the reconstruction of various oral cavity defects with acceptable cosmesis. We have described here the various innovations and modifications of this flap that can be used for the repair of different subsites of the oral cavity. Fifty-eight nasolabial flap reconstructions in fifty-seven patients with malignancy of lips and oral cavity patients were included and evaluated retrospectively. They underwent wide local excision of the tumour with or without mandibular resection and cervical lymph node dissection, as per their extent of involvement. In all these patients, the oromandibular and lip defects were closed using nasolabial flaps as single or twostage procedures. Flap survival, outcomes and complications, if any, were evaluated based on their respective reconstruction subsites. Buccal mucosa, gingivobuccal sulcus, lip, tongue, retromolar trigone, upper alveolus and hard palate are the various subsites repaired with nasolabial flaps. Two patients had partial flap loss, and one had complete flap necrosis. None of the patients had significant donor site issues, except four patients who had ectropion, for which ophthalmologist intervention was sought. Most of the oral cavity defects can be reconstructed with various modifications of the nasolabial flaps. Considering favourable aestehtic and functional outcome, it may be used as an alternative to free flap reconstruction in selected cases of small to medium defects with minimal donor site morbidity.</p>