Introduction: Hemiglossectomy, a surgical procedure involving the partial removal of the tongue, is commonly employed in the treatment of malignancies affecting this vital organ.The free radial forearm flap (FRFF) has emerged as a versatile and reliable option for tongue reconstruction, offering excellent functional and aesthetic outcomes. Case Reports: A 61-year-old male was referred to the Mongolian National University Hospital with a chief complaint of a posterior lateral tongue lesion that had manifested approximately one year ago.Notably, the patient had a 40-year history of smoking, and it was observed that his dental prosthesis did not fit well.On physical examination, a visible lesion was identified on the posterior lateral aspect of the tongue.Subsequent diagnostic workup revealed well to moderately differentiated squamous cell carcinoma and CT imaging uncovered metastatic involvement of the right side level 2-3 lymph nodes. Hemiglossectomy was performed to excise the primary lesion, and a free radial forearm flap facilitated reconstruction. Concurrently, neck dissection was carried out to address the metastatic lymph nodes. The patient received postoperative adjuvant therapy to optimize control of residual disease. Conclusion:Tongue reconstruction with a free radial forearm flap after hemiglossectomy is a viable and effective option, offering a reliable means to restore both form and function. The comprehensive assessment of this case underscores the importance of individualized treatment strategies and the potential for favorable outcomes in patients undergoing similar procedures.