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Our unit is one of the departments in the region, at the forefront in treating head and neck cancers in Pakistan. We have continued treating these patients in the COVID-19 pandemic with certain modified protocols. The objective of this study is to share our experience and approach towards head and neck reconstruction during the COVID-19 pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were a total of 31 patients, 20 (64.5%) were males and 11 (35.4%) patients were females. The mean age of patients was 52\u00a0years. Patients presented with different pathologies, i.e. Squamous cell carcinoma n\u2009=\u200926 (83.8%), mucoepidermoid carcinoma n\u2009=\u20092 (6.4%), adenoid cystic carcinoma n\u2009=\u20092 (6.4%) and mucormycosis n\u2009=\u20091 (3%). The reconstruction was done with loco-regional flaps like temporalis muscle flap n\u2009=\u200912 (38.7%), Pectoralis major myocutaneous flap n\u2009=\u20098 (25.8%), supraclavicular artery flap n\u2009=\u200910 (32.2%) and combination of fore-head, temporalis major and cheek rotation flaps n\u2009=\u20091 (3%). Defects involved different regions like maxilla n\u2009=\u200911 (35.4%), buccal mucosa n\u2009=\u20096 (19.3%), tongue with floor of mouth n\u2009=\u20096 (19.3%), mandible n\u2009=\u20094 (12.9%), parotid gland, mastoid n\u2009=\u20093 (9.6%) and combination of defects n\u2009=\u20091 (3%). Metal reconstruction plate was used in 3 (9.6%) patients with mandibular defects. All flaps survived, with the maximum follow-up of 8 months and minimum follow-up of 6\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pedicled flaps are proving as the workhorse for head and neck reconstruction in unique global health crisis. 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