Objective: 1) Describe a novel use of the internal mammary artery perforator (IMAP) fasciocutaneous rotation flap for hypopharyngeal reconstruction. Method: Case series at university-based tertiary care hospitals. We report 2 cases using the IMAP flap for hypopharyngeal reconstruction. We describe flap elevation and inset and the clinical course of the patients. Outcome measures were flap viability, pharyngocutaneous salivary fistula, and postoperative swallow function. Results: Case 1 was a 59 year-old male who underwent organ sparing protocol 5 years prior. He underwent laryngectomy for nonfunctioning larynx. Case 2 was a 58-year-old male with T4 squamous cell carcinoma of the larynx with pyriform sinus involvement. We performed a single flap in both cases. Each flap was based on the dominant internal mammary artery perforator vessels at the second and third intercostal spaces. There were no full or partial flap deaths. Both patients developed minor salivary fistulae that healed with conservative, nonoperative management. Both patients tolerated an oral diet within 5 weeks postoperatively. Conclusion: The IMAP flap is ideally suited for hypopharyngeal reconstruction and should be included in the armamentarium of reconstruction options. It is easy to harvest, thin, and pliable, and the arc of rotation allows for tension-free hypopharyngeal reconstruction. Salivary fistulas may occur.