Objective: To explore effective reconstruction of the defects of tongue following total glossectomy with extended vertical lower trapezius island myocutaneous flap. Methods: Eleven patients with advanced squamous cell carcinoma of the tongue were treated with glossectomy and repaired with extended vertical lower trapezius island myocutaneous flap based with the transverse cervical artery for the defect of tongue. The size of the skin paddle varied from 8 cm * 6 cm to 9 cm * 7 cm. Results: No major flap failure and no shoulder dysfunction occurred. All of the patients had uneventful postoperative courses and began to intake food perorally 8 to 15 days postoperatively. The patients were followed for 8 to 26 months (average 20.6 months). The function of the tongue for speech and swallowing were satisfactory. Conclusion: The extended vertical lower trapezius island myocutaneous flap was suitable for reconstructing total tongue defects following ablation of advanced tongue cancer. Keywords: tongue cancer, trapezius myocutaneous flap, reconstruction