Abstract Objective — to determine the role of facial artery musculomucous flap (FAMM-flap) in reconstruction of defects of the palate and alveolar process of the upper jaw, to designate topographic anatomy of defects of the palate and alveolar process, to determine the most convenient variants for positioning the flap leg in accordance with topographic location of the defect, to justify the safety of its use considering own clinical experience. Material and methods. There were 18 patients aged 6—60 years with a defect of the hard palate and/or alveolar bone and oronasal fistula. All patients were treated at the department of reconstructive, oral and maxillofacial surgery in 2015—2019. Linear dimensions of the defect ranged from 3 to 35 mm. All patients underwent surgical repair of the defect and oronasal fistula with FAMM-flap. Own method and classification were applied. In 15 (83.3%) patients with the defect of anterior and middle hard palate, the flap included anterior segment of m. buccinator with axial blood supply from a. facialis with reverse blood flow (FAMM-flap modification). Flap on the perforant branch of the facial artery was harvested in 2 (1.1%) of these patients. In 3 (16.6%) patients with the defect of posterior hard palate, the flap included posterior segment of a. buccinator with reverse blood flow (Bonzolla-flap modification). Bilateral flaps were used in patients with large defects (over 3.3 mm). Results and conclusion. Procedures were successful. Postoperative complications included ischemia of the end fragment of the flap (11.1%) without significant effect on the outcome. Major complications were not observed. FAMM-flap is reliable, convenient, multifunctional flap. This method is effective for correction of the defects of various size, localization and etiology.