Background The scapular tip free flap (STFF) is becoming more popular for oromandibular reconstruction. This article reviewed the early and late outcomes in a larger series over 9 years. Methods We conducted a retrospective review of all consecutive patients who underwent oromandibular reconstruction using the STFF at London Health Sciences Centre. Demographic information, surgical data, and complications were collected and analyzed. Results From April 2008 to March 2017, 81 STFFs were performed in 80 patients. The average bony reconstruction measured 5.4 cm. Bone-only flaps were utilized in 24 cases (29.6%). Five cases (6.2%) required a single osteotomy. There were 3 (3.7%) flap failures. There were 7 plate extrusions and 11 cases of radiographic nonunion. Conclusion The STFF is a reliable option with acceptable early and long-term results. The STFF may be considered as a first line option especially for shorter bone defects or in conjunction with complex soft tissue requirements