Objective To explore the clinical effects of radial forearm free flap（RFF）and the anterolateral thigh flap (ALT) in defect reconstruction after soft palate cancer surgery, and to compare the differences between the two flaps in terms of repair effect,functional recovery and tumor prognosis. Methods A retrospective analysis was conducted on the clinical data of 25 patients with soft palate cancer admitted to the Second Affiliated Hospital of Fujian Medical University from November 2017 to June 2025. Among them,13 cases were repaired with RFF (RFF group), and 12 cases were repaired with ALT (ALT group). The intraoperative parameters (flap area, vascular pedicel length, preparation time), postoperative complications (flap necrosis, pharyngeal fistula, bleeding, etc.) and functional recovery (swallowing, speech, nasopharyngeal reflux) of the two groups of flaps were compared, and the tumor recurrence rate and survival rate were evaluated.Results The survival rates of the flaps in both groups were relatively high(P=0.740).The flap area in the RFF group was significantly smaller than that in the ALT group(P=0.003),and the preparation time was longer(P=0.042).There were 3 and 2 cases of complications after the operation in the RFF group and the ALT group respectively (P=0.541).Functional assessment showed that both groups of flaps achieved good results in functions such as speech, swallowing and nasopharyngeal reflux after surgery (all >0.05),but the RFF group was better than the ALT group in terms of speech function and swallowing function,and the RFF group was worse than the ALT group in terms of asopharyngeal reflux.There was no significant difference in postoperative complications and survival rate between the two groups (all P> 0.05),but the recurrence rate and risk of distant metastasis were higher in the ALT group.Conclusion Both RFF and ALT are effective options for postoperative defect reconstruction of soft palate cancer,but individualized selection should be made based on the defect range,tumor stage and functional requirements.