Abstract: Background - Major ablative surgeries leads to soft and hard tissue defects which require reconstruction which gives better functional and aesthetic outcomes. Pectoralis major myocutaneous (PMMC) flap is a workhorse flap for soft tissue reconstruction owing to its merits. The conventional technique of harvesting PMMC flap is associated with donor site complications such as functional deformity and scar contracture. A modified technique without lateral axillary incision for harvesting PMMC flap may provide better results. Aim - To compare the two incision designs of harvesting PMMC flap (with lateral axillary incision and without lateral axillary incision) in soft tissue defect reconstruction in head and neck region. Methodology – A prospective pilot study will be performed on 16 patients diagnosed with OSCC requiring resection, neck dissection and reconstruction with PMMC flap. These patients will be allocated to two groups by alternate randomization, Group A PMMC flap harvest with lateral axillary incision and Group B PMMC flap harvest without lateral axillary incision. The patients will be subjected to General anaesthesia and surgery will be performed by single experienced surgeon. Parameters assessed will be time taken for harvesting the flap, time required for closure of donor site, flap survival, range of motion (ROM) of shoulder (Degree of endorotation and exorotation), complications (hematoma, seroma, dehiscence, marginal necrosis, infection) and scar formation. The obtained data will be filled in MS excel sheet and statistical analysis will be done. Expected result – The modified technique would prove better in terms of function and aesthetic with minimal complications and that it will provide new insight in choosing the best approach with minimal complications for harvesting of PMMC flap. Conclusion - The results if favours the modified technique with respect to time of harvesting, time of closure of donor site and complications, will help in the reconstruction of such defects with minimal donor site complications and improved outcomes.