Purpose: Free fibula flap reconstruction has become a standard procedure for mandibular reconstruction following ablative surgery. Achieving optimal aesthetic and functional outcomes relies on precise reconstruction of the mandibular contour. This abstract explores the innovative use of an anaesthetic bougie as a template for intraoperative shaping of the neo-mandible, facilitating accurate osteotomies of the free fibula flap. This technique is presented as an alternative to pre-bent reconstruction plates and 3D reconstruction models. Methodology The anaesthetic bougie, traditionally employed in airway management, is a malleable tool with strong memory characteristics. In this novel approach, the sterile bougie is positioned along the native mandible pre-resection and shaped to create a template for the neo-mandible. Planned resecting osteotomy sites are marked on the bougie. This is then taken to a side table and used to perform osteotomies and plating of the fibula flap. Results This technique offers a cheap, flexible, and accurate alternative to costly and time-consuming Virtual Surgical Planning (VSP) 3D models. While VSP allows for detailed preoperative planning, it fails to allow for intra-operative changes to the resection. The anaesthetic bougie offers real-time adaptability and customisation, ensuring a bespoke reconstruction that is readily available. It is useful if pre-bent mandible reconstruction plates are not suitable or available. Conclusion Incorporating an anaesthetic bougie for intraoperative templating of the native mandible represents a valuable adjunct in the armamentarium of techniques for free fibula flap reconstruction and is a practical alternative to 3D reconstruction models.