Background: The anterolateral thigh flap(ALT)has been the current workhorse for the soft-tissue defects reconstruction.In this article,we describe the use of chimeric free ALT perforator flaps to reconstruct complex three-dimensional spatial soft-tissue defects in the head and neck.Methods: Fifteen patients who had complex multiple anatomic sites defects after malignant tumor wide excision surgery,received reconstruction based on the free multipaddled chimeric ALT flaps.10 patients were diagnosed as buccal cancer,4 patients were tongue cancer with submandibular skin invaded,and 1 patient was submandibular skin cancer.All patients were examined preoperatively with a portable super Doppler probe to detect and locate the perforators which originate from the lateral circumflex femoral artery.The flaps were created with two or three paddles using independent perforators which originate from the lateral circumflex femoral system that joined to the same mother vascular source were identified.In this series,11 cases were used with bipaddles anterolateral thigh chimeric flaps to reconstruct defects,and others were with tripaddles anterolateral thigh chimeric flaps.The paddles range in size from 5.0 × 5.0 cm to 12 × 7.5 cm.Results: All flaps survived.Only one case which we used split thickness skin graft to cover the defect of recipient region,and donor sites of others were closed primarily.After a mean follow-up time of 11.3months,there were no obvious complications with the donor and recipient sites.Conclusion: The multipaddled anterolateral thigh chimeric perforator flap is a good and reliable alternative for reconstructiong complex soft tissue defects of the head and neck.