Objective To investigate the clinical anatomy of free femoral artery perforator flap and its application in the repair of postoperative defects of oral and buccal cancer. Methods From December 2015 to June 2019, 13 patients with orobuccal cancer underwent orobuccal repair with free femoral artery perforator flap, all male patients, aged 37 ~ 61 years, with an average of 48.5 years. The pathological types were squamous cell carcinoma. According to the TNM stage of UICC, there were 5 cases of T4N0M0, 2 cases of T4N1M0, 2 cases of T3N1M0 and 4 cases of T3N2M0. The course of disease was 3 ~ 16 months, with an average of 9.8 months. The harvestion forms of free femoral artery perforator flap include: ① simple perforator flap in 7 cases, ② perforator chimeric myocutaneous flap in 6 cases. Results The size of the flap ranged from 6.5cm×4.0cm to 10.0cm×6.5cm. The thickness of the flap was 2.5 to 3.5 cm. The length of the vascular pedicle was (6.2 ± 0.4) cm, and the donor site of the medial thigh was directly closed. All 13 flaps survived, and the wounds healed smoothly. All patients were followed up for 12 ~ 30 months, with an average of 21.3 months. The reconstructed buccal shape was not bulky, there was no hair growth, the function recovery was satisfactory, there was no local recurrence of the tumor, and 2 cases had cervical lymph node metastasis. Only linear scar was left in the donor area, and there was no significant effect on thigh function. Conclusions Free femoral artery perforator flap can be used to repair buccal defect after radical resection of buccal cancer.