The supraclavicular artery island flap (SCAIF) was popularized by Pallua et al. in the 1990s, although the use of cutaneous flaps from the shoulder dates as far back as 1842. Despite a long history, it was not until the vascular anatomy of the region was better defined that the flap became a reliable reconstructive option. Lamberty and colleagues described the supraclavicular artery in 1979 as the specific branch of the transverse cervical trunk that could be utilized for a local flap. The SCAIF is a reconstructive option for many defects in the head and neck, with the benefit of decreased total operative time, length of stay, donor-site complications, and cost when compared to free flap options.