The implantation of cancer cell is uncommon but well recognized complication. Immediate flap reconstruction after tumor resection now is the main treatment method for head and neck cancer surgery, but the risk of dissemination of cancer cell to flap donor site existed. We presented a case of L't lower gingival SCC, received immediate free anterior lateral thigh flap reconstruction after tumor wide excision, then dissemination of cancer to flap donor site was noted. This reviewed article discussed the etiology and how to prevent it during surgery.