Reconstruction of the oral tongue following cancer resection is best performed with attention to the surgical defect that has been created and the probable deficits in speech and swallowing. For the anterior oral tongue, preservation or reconstruction of a mobile sensate tip is the goal. For the mid‐third oral tongue, restoration of both tissue bulk and mobility are the goals. For the posterior third oral tongue, tissue bulk to aid in food bolus transport and palato‐glossal contact is the goal. Various reconstruction options exist for each site, ranging across the spectrum of primary or secondary closure, skin grafts, intraoral flaps, extraoral pedicled flaps and free flaps. Based on the surgical defect, these reconstructive options are evaluated for their contribution to restoring functional deficits.