Objective — to improve the results of microsurgical reconstruction of head and neck in cancer patients by optimizing ultrasound examination of vessels and their anastomoses. Material and methods. The study enrolled 100 patients with head and neck tumors. Donor and recipient vessels were studied in primary 50 patients with head and neck tumors and 50 patients after combined preoperative treatment. All patients underwent ultrasound examination before and after reconstructive surgery. A 47-year-old patient with squamous cell carcinoma of the alveolar process of the mandible is reported in the article. Results. There were edematous changes in transplant’s fatty tissue on the 1st and the 3rd postoperative day. Therefore, it was impossible to visualize arterial anastomoses less than 1.5 mm in diameter and venous anastomoses in gray scale ultrasound mode. These changes were reduced after 7 days. There were no vascular complications after microsurgical repair in all patients on the 1st postoperative day. Thrombosis of venous anastomosis occurred in 2 patients after 3 days. Hematomas up to 1.5—3 cm with lysed content were observed near vascular anastomoses in 6 patients after 3 and 7 days. These hematomas did not impair blood flow in the graft. Conclusion. Complex ultrasound examination is useful to design a flap with the most optimal characteristics of donor perforating vessels. This method is also valuable for postoperative survey of vascular anastomoses and autograft. In turn, it is useful for prevention of complications.