The reconstruction of maxillectomy defects is a complex problem encountered in plastic surgery. Defects can range in size and complexity from small defects requiring only soft tissue, to complete maxillectomies requiring large tissue bulk, bone, and one or more skin paddles. The most difficult defects involve the skull base and orbit. The reconstructive surgeon is faced with the challenge of isolating the nasopharynx from the dura and globe, while simultaneously restoring the bony framework of the maxilla and orbit to support the soft tissue of the cheek. We present a series of five reconstructions using a rectus abdominus muscle flap with associated vascularized rib for reconstruction of complex maxillectomy defects. This flap provides large soft tissue bulk as well as bony support and a long vascular pedicle. A large skin island can be taken with the flap, and the donor site morbidity is comparable to a VRAM flap. Five flaps were performed in four patients over a 13 month period. All patients had a stable support of the orbit at follow-up with adequate soft tissue coverage, and there were no incidences of visual changes.