Soft tissue free flaps designed from the subscapular vascular system have evolved since their first reports in the 1980s. The scapular and parascapular flaps are fasciocutaneous or adipofascial flaps, with or without an osseous component, based off the circumflex scapular artery that can be used to reconstruct large defects while still permitting primary closure of the donor site. While historically performed from the prone position, dissection of the subscapular system can be approached from the lateral decubitus and even supine positions, allowing simultaneous flap harvest and tumor resections. Thus, the scapular and parascapular flaps are valuable flaps for the head and neck reconstructive surgeon.