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This publication focuses on the comprehensive surgical approach to mandibular reconstruction using the fibula free flap (FFF), a cornerstone technique in modern head and neck reconstructive surgery. It presents the current state of the art, including detailed anatomical, technical, and clinical aspects of FFF harvest, shaping, and integration, particularly in oncologic settings. Emphasis is placed on indications, surgical planning, flap design, microvascular techniques, and postoperative management, supported by updated literature and high-resolution surgical iconography. Aimed at maxillofacial surgeons, otolaryngologists, and plastic surgeons, this work highlights practical decision-making frameworks and explores advanced procedures like double-barrel techniques for height restoration. It also covers complications, limitations, and flap alternatives in patients with vascular risks or complex anatomical challenges. This monograph is intended for academic and clinical use, making it an essential reference for surgeons in training and specialists seeking to refine their reconstructive protocols.