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A rare complication of flap reconstruction following oncologic ablation is metastasis to the donor site. We present a novel case of cutaneous squamous cell carcinoma (SCCA) recurrence at the right upper‐extremity donor site following tonsillar SCCA resection with supraclavicular artery island flap reconstruction. Following surgery, the patient presented with cutaneous recurrence at the right upper‐extremity donor site. Biopsy confirmed metastasis from the oropharyngeal primary. The patient developed two subsequent right upper‐extremity recurrences before he died. The most likely mechanism of metastasis is direct implantation via contamination. This case demonstrates the importance of maintaining separate surgical fields and instruments during oncologic ablation and reconstruction. Laryngoscope, 131:E440–E442, 2021

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