Abstract One hundred and five deltopectoral flaps were raised in 100 patients. Fifty-four were delayed prior to use and 51 flaps were used immediately without delay. Delay was used whenever there was a high probability of impaired healing or a modification of a portion of the flap was necessary. In patients with delayed flaps there was major loss in 16.6 per cent and minor loss in 9.2 per cent. In immediate reconstruction of the flap, major loss occurred in 15.7 per cent and minor loss in 17.6 per cent. The most frequent major flap losses occurred during attempts to reconstruct the palate. Placement of the flap into a previously radiated tissue bed, diabetes, and wound infections were the major contributing factors to major flap loss in both groups of patients.