The study, titled "A Study of Microvascular Reconstruction of Oral and Maxillo-facial Defects" aims to fill the gap in region-specific data on head and neck reconstruction using free flaps in India. Free flaps are currently the gold standard for reconstruction of head and neck defects after ablative oncosurgery. They have significantly improved patient outcomes especially when the defects are three dimensional and extensive. The aim of this 5-year retrospective study is to analyze the outcomes of free tissue transfers in the head and neck area in the Department of Plastic and Reconstructive Surgery of a tertiary care hospital in North India, from March 2019 to September 2024. Patient demographics, comorbidities, flap characteristics, outcomes and complications were assessed. A total of 42 free flaps were performed after oncologic resection. The Radial Artery Forearm free flap was the most commonly used flap followed by Antero-lateral thigh flap. Our overall flap success rate was 95%, while the overall complication rate was 17%. Free tissue transfer in head and neck reconstruction is reliable and with meticulous surgical technique and competent anaesthesia care, the complication rates remain low. Adjunctive treatments like radiation and chemotherapy can also be given alongside without affecting flap survival.