Purpose Reconstruction of tongue defects after tumor resection is important to regain the form and function including the speech and swallowing. This study attempts to review the reconstructive options after glossectomy and to propose a classification system to aid the selection of right reconstructive option. Material and Methods A retrospective review of 337 patients of carcinoma of the tongue treated surgically. The study period was between January 2004 and December 2010. The cases underwent glossectomy and appropriate primary reconstruction. A prospectively maintained clinical data base and electronic medical records were reviewed for clinical, surgical details and morbidity. Results Eighty-three patients underwent reconstruction with radial forearm free flap (RFFF). 59 patients had lateral arm flap (LAF) and free anterolateral thigh (ALT) flap was used in 37 patients. A local or regional flap like pectoralis major myocutaneous (PMMC) flap, submental flap or nasolabial was used in 20 patients. The defects in 141 patients were primarily closed or left raw to heal after laser resection. Larger defects had poor speech and swallowing outcome. Anterior defects correlated with poor speech and posterior defect had poor swallowing results. A classification system to aid the selection of right reconstructive option is proposed. Class I: Defects where less than one third of the volume of the tongue is resected, Class II: Defects where more than one third but less than half the tongue is resected, Class III: Defects where more than half but less than a total glossectomy, Class IV: Total glossectomy. Each class is subdivided into a: lateral defects, b: lateral and base defects and C: a/b + Sulcus defects (where floor of mouth or marginal mandibulectomy is done). The distribution of the defects were Class I ( n = 141), Class II ( n = 112), Class III ( n = 67) and Class IV ( n = 19). Class I defects need no reconstruction except for I b that needs reconstruction, ideally with Lateral arm flap. The need for reconstruction in Class II defects is controversial. If reconstructed, II a, b are best reconstructed with lateral arm flap and II c defects with Lateral arm flap, submental flap or radial forearm flap. Class III defects are bulk defects. III a defects are best reconstructed with Lateral arm or ALT flap. Class III b defects with ALT and class III c defects with Radial forearm/laterally thinned Anterolateral thigh (ALT). Radial forearm flap or laterally thinned ALT helps to form the sulcus. Class IV defects are reconstructed with ALT/rectus abdominis free flap or a combination of gastro-omental with Gracilis flap to achieve a dynamic tongue reconstruction. Conclusions This study proposes a classification for the defects after glossectomy. This helps in the selection of the right reconstructive choice.