The radial forearm free flap (RFFF) was developed in the early 1970s but not published until 1981. This technique was pioneered by Dr Yang and the team at the Shenyang General Hospital, China. The first case series of 56 patients were based on Dr Yang’s findings of its feasibility through the upper limb of human cadavers. It was later known worldwide as the pedicle flap based on the retrograde flow from the palmar arch after being reported by Biemer and Lu. The RFFF can easily be assessed pre-operatively with an Allen test. RFFF provides the benefit of a long vascular pedicle that can be designed to accommodate different defects. It is time-honoured as it can be completed as a one-stage procedure to reliably cover large defect especially in the hand. It remains as an option for head and neck reconstruction with its ability to provide thin and malleable soft tissue coverage.