Cancers of the head and neck pose a unique surgical dilemma given the complexity and functionality of the structures within this region. The jejunal interposition or free flap has become one of the most widely employed reconstructive techniques for such defects with evidence to support robust functional outcomes. As head and neck cancers become increasingly survivable with advances in multimodal treatment, consideration of long-term outcomes of treatment is imperative for decision-making and patient care. The aim of this study is to review long-term functional and mortality outcomes for head and neck cancer patients who have undergone jejunal free flap reconstruction for pharyngolaryngectomy defects. We reviewed twelve years of retrospective data, from 2012 to 2024, for patients who have undergone this reconstruction at our institution: the Princess Alexandra Hospital Head and Neck Clinic in Brisbane. We have identified 65 patients meeting criteria, and documented patient background, pre-operative status, operative details, complications, speech and swallow outcomes, and mortality. The cohort will be one of largest from a single institution of such patients. Preliminary data has found few complications and good functional outcomes, comparable to the 201-patient retrospective study conducted at our institution in 1995 (1). Hence, we aim to demonstrate that the jejunal interposition flap remains a suitable and robust reconstructive option following pharyngolaryngectomy. 1. Theile DR, Robinson D, Theile DE, et al. Free jejunal interposition reconstruction after pharyngolaryngectomy. Head Neck 1995;17:83-88.