Mandibular reconstruction is necessary to overcome the problem that segmental mandibulectomy or hemi-mandibulectomy causes the loss of mandibular contour and decrease of oral function. Among the various methods reported, we usually use a vascularized scapular flap for the reconstruction. Between April 2001 and November 2009, 77 mandibular reconstructions were performed in 76 patients. Diseases that necessitated mandibular resection were malignant tumors in 55 patients, benign tumors in 18 patients and radiation osteonecrosis of the mandible in 4 patients. According to the CAT classification of mandibular defects, “A” was the most common (33.8%), followed by “A” (26.0%). Osteotomy of the scapular bone was performed in 42 cases (54.5%) to replicate the contour of the mandible. The most common defect of soft tissue was the mucosa (87.0%). Scapular flap combined with latissimus dorsi flap can be used to reconstruct large defects of the soft tissue. Repositioning of mandibular segments during the operation is mandatory to maintain post-operative oral function. The scapular osteocutaneous compound flap is considered to be a useful method for mandibular reconstruction.