The osteocutaneous radial forearm free flap (OCRFF) is a reliable reconstructive option for many oromandibular and maxillary defects. Arterial supply to the flap is from the radial artery. The venous system includes the venae comitantes of the radial artery as well as the cephalic vein. The OCRFF provides a reliable, thin, and pliable soft tissue/skin paddle and an adequate amount of bone that is ideal for many intraoral defects. With stable intraoperative fixation, the donor site morbidity of this flap has improved over time.