The Pectoralis Major flap is a reliable and versatile flap for head and neck reconstruction. However, it is associated with donor site scarring on the anterior of the chest wall.Endoscopic assisted harvest of a pedicled pectoralis major muscle flap was performed on three patients for head and neck reconstruction. The average incision length was 4.5cm, the average time taken to harvest the muscle was 37min. All patients were discharged from hospital on the 5th to 8th postoperative day and one patient had a seroma.Endoscopic harvest of the pedicled Pectoralis major muscle flap minimises postoperative scarring.