Objective To reconstruct the maxillary defect by usingfree vascularized iliac osteomusculocutaneous flap combined with immediate zygomatic implantation for early rehabilitation of maxillary contour and masticatory function. Methods In August 2003, the patient presented with deformity ofleft middle face(Brown Ⅱ type defect) after subtotal maxillectomy. After hospitalization, a set of preoperative preparations were made, including spiral CT scanning, manufacture of nature size anatomical model and implantation protocol design. The maxillary defect was reconstructed with free vascularized iliac osteomusculocutaneous flap combined with simultaneous insertion of one Br¨nemark zygomatic implant and two general implants. Six months later the prosthesis were placed. Results The vascularized osteomusculocutaneous flap survived, the osseointegration was observed between bone and implant 6 months later. The contour of face and palate was satisfactory, the normal occluding relation was gained. The average masticatory force of operative side was 76.3% of the normal side. No tumor recurrence was noticed during the follow-up of 14 months. Conclusion It is a reliable method for functional reconstruction of maxillary defect via vascularized iliac osteomusculocutaneous flap combined with immediate zygomatic implantation.