All free vascularised fibula grafts performed at our unit were assessed retrospectively with respect to success and complications. Between 2007 and 2014 there were 11 males and 9 females with a follow-up from 2 to 6 years. The mean bony defect length was 14 cm. Bony union was assessed radiographically and was seen in 18 cases. One flap failed and another was salvaged despite anastomotic failure. There was one post- operative death. Otherwise serious complications and donor site morbidity were acceptable. Vascularised fibula reconstructions should be considered a valuable treatment option for patients with hemimandibular or segmental mandibular defect reconstructions of more than 9.5 cm. Paying greater attention to detail will help minimize and prevent postoperative complications.