Four consecutive patients underwent composite resection of tonsillar cancer and reconstruction with a microvascular radial forearm free flap. Three patients had postoperative assessments of speech at six to nine months respectively. One patient could not attend for the postoperative assessment. The speech assessment was examined by same speech therapist. All the patients had an good postoperative speech assessment. Compared to conventional local or regional myocutaneous flaps, the thin forearm free flaps offers better postoperative articulatory recovery.