Soft tissue reconstruction in oral cavity defects are challenging surgery for crucial maintaining the oral cavity integrity and function. Tongue is one of the most versatile organ used for providing tissues required for reconstruction of oral cavity defect. Its abundant blood supply permits different flap design according the anatomy of the reconstructed area. Twenty one patients (15 M & 6 F) sustained different anatomical defects at the oral cavity post tumor ablation and congenital anomalies .The patient age ranged from 13 to 74 years with mean age 43 years. Routine admission laboratory investigations were done for every patient, patient with tongue pathology were exempted from the study. The cases were selected and treated at the Oral and Maxillofacial Surgery Department Shebin Al Kom Teaching Hospital Egypt . Oral cavity reconstruction was done in 12 cases by anterior based tongue flaps while in five cases posterior based tongue flaps were used, Island flap in two cases and both ventral and dorsal sides for lip reconstruction in further two cases .The criteria of using tongue flaps and the difficulty encountered post operatively were managed according each patient tolerability to the nasogastric tube and the save way to divide the tongue flaps without compromising the airway and tongue motility .The results of this modality was 91% success but certain limitation was encountered entail the use of other modality as well as early dehiscence with secondary healing by fibrosis. Our conclusion is the good selection of cases is very important for successful soft tissue replacement as the skill of reconstruction is still too much exceed the skill of resection.