Recently, the Department of Oral and Maxillofacial Surgery of our hospital successfully reconstructed the tongue organ for a patient with advanced tongue cancer by removing the left tongue mass and freeing the remaining half of the tongue with a (thigh) anterolateral femoral flap, which is the first time such a difficult operation has been performed in Foshan. Patient Ou, male, 65 years old, found an ulcerated lump on the left tongue edge four months ago, and was given anti-inflammatory treatment in other hospitals, but the lump did not subside and was repeatedly swollen and painful. When he came to our stomatology department for treatment, the doctor found that Mr. Ou had a cauliflower-shaped mass about 4×2.5×2cm in size in the middle and posterior part of his left tongue, with hard texture and insignificant tenderness, and a large tumor lesion extending to the bottom of the mouth, with mild restriction of tongue body movement and multiple enlarged lymph nodes palpable in the neck; tongue cancer was considered a possibility. After admission, the biopsy showed that the tumor was a medium to high differentiated squamous cell carcinoma of the left tongue margin. Considering the large size of the lesion and the old age of the patient, in order to completely and radically remove the tumor, prolong the patient’s life and improve the postoperative quality of life, the physician formulated a well-designed surgical plan after sufficient preoperative examinations, and proposed to perform an enlarged resection of the left tongue cancer plus lymph node dissection of the neck and a free flap repair of the anterolateral femur of the left thigh. The surgeon first performed the left cervical lymph node dissection, prepared the donor vessels (external maxillary artery, common facial vein and external jugular vein), then cut the periosteum of the lower edge of the mandible to fully expose the lesion, radically resected the tumor 1 cm outside the complete border of the tongue tumor, cleared the floor of the mouth, and sent the cervical lymph nodes and the surgical margin tissue for frozen pathological examination to ensure that no tumor remained. The anterolateral femoral flap was then cut approximately 5×10 cm in size, and the tongue was reconstructed by microscopically anastomosing the vessels of the anterolateral femoral flap with the vessels of the neck. Due to the poor vascular condition of the donor area, the inner diameter of the vessel was less than 1.5mm, which was 4 times different from the caliber of the recipient vessel, making the anastomosis extremely difficult. After the operation, with the careful treatment and care of medical staff, the patient successfully passed the difficulties of infection, thrombosis and swelling and was discharged from the hospital. At present, the patient’s general condition is good and the recovery of tongue shape, speech and chewing function is satisfactory. Surgery is the main means to treat oral cancer, which will leave a large area of defect after surgery. The previous surgical method is to close the wound by directly drawing together the excised wound or suturing the adjacent tissues with the remaining tissues to close the wound, but this method will cause serious deformity and functional disorder, which will affect the survival quality. Some advanced oral cancers with extensive infiltration and excised wounds that are difficult to be repaired by simple means are considered to have no indication for surgery and receive palliative care or abandon treatment, with poor prognosis. At present, the international judgment of the technical level of an oral and maxillofacial surgery is whether it can perform functional surgery on patients. This time, only one group of surgeons successfully performed tongue reconstruction with anterolateral femoral flap, which is an important sign that our head and neck tumor surgery repair technology has reached the advanced level in China. At present, the Department of Oral and Maxillofacial Surgery of our hospital has been able to skillfully carry out various repair and reconstruction techniques such as free forearm flap, free peroneal muscle flap, anterolateral femoral flap, latissimus dorsi muscle flap and pectoralis major muscle flap. The development of functional surgery and the application of various repair and reconstruction techniques not only ensure the successful completion of the surgery to a certain extent, but also give maximum restoration to the patient’s appearance and function, reduce the patient’s mental trauma and pain, shorten the course of treatment, and facilitate the early resumption of normal social life.