ObjectiveTo investigate the characteristics and treatment modalities of malignant tumors originating from the sublingual gland, as well as evaluate the therapeutic outcomes following free flap reconstruction. MethodsA retrospective statistical analysis was conducted on the clinical data of nine patients diagnosed with malignant neoplasms of the sublingual gland. ResultsThe aggregate of nine instances of malignant neoplasms arose from the sublingual glandular tissue, encompassing eight instances of adenoid cystic carcinoma (ACC) and a single case of a bipartite differentiated carcinoma—a hybrid of epithelial-myoepithelial carcinoma and adenoid cystic carcinoma. In addition, there were four instances where anterolateral thigh flaps were employed (of which three were thin flaps), and five instances utilized forearm flaps. The flap incisions varied in size, with dimensions spanning from 2.5 cm × 6 cm to 4 cm × 9 cm. The vessels chosen for anastomosis were the superior thyroid artery in seven cases, the facial artery in a singular case, and the lingual artery in another. Among the eight patients who underwent dissection of cervical lymph nodes, not a single one exhibited metastasis. A duo of patients underwent adjuvant radiotherapy as an integral component of their treatment regimen. Upon postoperative follow-up, recurrence was absent in all of the patients documented. ConclusionThe thinning of the anterior external thigh flap can be employed for postoperative repair and reconstruction of malignant sublingual gland tumors, minimizing patient trauma.