Microvascular free tissue transfer has become a well-established technique in head and neck cancer reconstruction, offering a single stage definitive procedure. Defects requiring soft tissue bulk have been reconstructed in the past using a variety of flaps, including skin and subcutaneous tissue flaps, such as scapula and lateral arm. Muscle flaps have also been used, however the long term results can be unpredictable, due to muscle atrophy. The Deep Inferior Epigastric Perforator (DIEP) flap is a relatively new flap, developed as a modification of the TRAM flap, and has been used predominantly in breast reconstruction. It can be harvested in a vertical or horizontal direction, and unlike the TRAM flap, avoids sacrifice of the rectus muscle. Patient repositioning is not required, and flap harvest can be performed at the same time as tumour ablation. Dissection of the perforators can be technically difficult, and there is a definite learning curve with the technique. Despite this, a long pedicle can be harvested, thus facilitating flap inset in the head and neck region. We feel the DIEP flap is a useful flap in one’s armamentarium for head and neck reconstruction, and now describe our experience with 12 cases.