A retrospective study was conducted at Dr Bhubaneswar Borooah Cancer Institute, Guwahati Assam in 55 patients who had undergone free flap reconstructive surgery following resection of head and neck cancers over a period of 2 years from 2018 to 2020. General anaesthesia with either endotracheal intubation or cuffed tracheostomy tube was used. Anterolateral thigh, radial forearm and free fibular flaps were used for reconstruction. The mean anaesthesia time was 29.8 hours which included the time from induction to extubation. Out of which the surgery mean time was 10.6 hours. Of the 55 free flap surgeries, there were 4 failures, two of which were intraoperative leading to the surgeon abandoning the procedure. Optimal utilization of advanced anaesthesia techniques as well as improvement in surgical expertise can further increase the use as well as reduce the complications associated with free flap surgeries.