Enhanced Recovery After Surgery （ERAS） is a package of various evidence-based perioperative management methods that enhance the quality of postoperative recovery. The Japanese version of the Quality of Recovery score （QoR-40J） is a clinical outcome which is widely used to evaluate the quality of recovery after surgery under general anesthesia. We evaluated the quality of recovery using the QoR-40J in 10 patients who had been managed according to our ERAS protocol for head and neck surgery followed by free tissue transfer reconstruction. We were able to conduct the ERAS protocol safely and to obtain QoR-40J scores in all patients. The mean overall score of QoR-40J significantly decreased from the day before surgery to postoperative-day （POD） 1, and tended to recover gradually from POD 2 to POD 7. It was suggested that the score trends of QoR-40J reflected the quality of recovery after head and neck surgery followed by free tissue transfer reconstruction. We would like to use the QoR-40J as an indicator to improve perioperative management and to construct a new standard of the ERAS protocol for head and neck surgery.