Introduction: Although free flap transfer is commonly performed to reconstruct defects to the upper 2/3’s of the head and neck, the superficial temporal artery and vein (STA/V) have rarely been described as recipient vessels. The purpose of this study was to determine the indications for, and the effectiveness of using the STA/V for microvascular head and neck reconstruction. Methods: From 1996 to 2002, 217 consecutive patients underwent microvascular reconstruction for head and neck cancer defects. From this group of patients, 40 free flaps were performed with the STA/V as recipient vessels in 37 patients and were analyzed separately. Retrospective chart review was used to determine patient demographics, pathology, size of defect, flap transferred, post-operative course, complications, and length of follow-up. Results: Patient age ranged from 2 to 91 years (median: 63yrs). The areas of reconstruction included: scalp defects (19), orbital defects (14), cranial base defects (4), and midface defects (3). Flap selection included the rectus abdominis (19), radial forearm (10), latissimus (7), and scapular flap (4). Five flaps required re-exploration within the first 24 hours post-op, three for venous thrombosis and two for arterial thrombosis. Subsequently, four of five flaps were salvaged. The remaining patient was reconstructed with a free flap to the same STA/V. Conclusions: 1. The use of the STA/V as recipient vessels for head and neck microsurgical free tissue transfer is reliable and safe. 2. The choice of STA/V as recipient vessels does not limit the free flap selection for upper face/scalp reconstruction. 3. The STA/V should be routinely considered for defects involving the upper 2/3’s of the face.