Oral cavity cancer presents unique challenges due to the region’s complex anatomy and vital functions.While microvascular reconstruction is the gold standard, it may not always be feasible due to limited resources, accessibility, advanced disease, or high post-operative care demands. This practical color atlas draws on the authors’ extensive experience to highlight local and regional flaps as effective alternatives in suitable cases.Featuring case examples, step-by-step guides, clear photographs, and access to operative videos, it provides a comprehensive yet accessible approach to reconstruction. This color atlas serves as a valuable resource for both junior and senior colleagues in the field of oral cancer surgery.It offers a collection of cases to inspire alternative approaches when standard solutions may not suffice. Surgical excellence lies in simplicity. While all authors are fully trained and practicing microvascular surgeons, the ability to achieve effective reconstruction with the appropriate technique is an art in itself.