Free jejunal flap transfer in hypopharyngeal reconstruction is an established method, but it is true that it has unavoidable complications, such as total necrosis or fistula formation. A total of 360 jejunal flap transfers with multiple vascular pedicles were performed at our institute from 2001 to 2017 without total necrosis, and fistula formation occurred in 12 cases （3.3％）. To reduce postoperative complications, one of the most important points is team practice among head and neck surgeons, plastic surgeons and digestive surgeons. Preserving cervical vessels and surgical margins in good condition enables reconstructive surgeons （not only plastic surgeons but all members of the team） to perform safe and reliable reconstruction.