Main disadvantages of conventional pectoralis major myocutaneous flap is bulkness of muscular pedicle. It makes difficult to use this flap in a case of supraomohyoid neck dissection. Pectoralis major myocutaneous island flap is a modification to overcome this shortcoming. And bilobular design of skin portion of this flap could be used for reconstruction of a through and through defect. We report a case of reconstruction of full-thickness defect of cheek with bilobular pectoralis major myocutaneous island flap and compare it with conventional pectoralis myocutaneous flap.