BACKGROUND: Increasing numbers of super-elderly patients (>80 years old) with cancer now require microvascular-free tissue transfer. The objectives of this study were to evaluate potential applications of microvascular tissue transfer in this patient population, and post-surgical changes in quality of life. METHODS: The records of cancer patients 80 years or older who had undergone microsurgical tissue transfer were retrospectively reviewed. Structured interviews were conducted with patients and family caregivers after surgery, and the patients'quality of life was qualitatively assessed. RESULTS: The study cohort consisted of seven patients with a mean age 87.6 years (range, 81 to 95). Wound and medically-related complications were minimal. During the patient interviews, eight of the nine respondents reported remarkable improvements in quality of life following surgery and expressed a high level of satisfaction with their surgical results. CONCLUSIONS: Our study showed that microsurgical reconstruction performed in super-elderly patient not only appropriately repairs post-oncologic defects but also significantly improves the patients' quality of life.