Abstract: Objective: To apply serial digital guide to the reconstruction of mandibular defect with fibular myocutaneous flap, realizing accurate and individual reconstruction of mandibular defect. Methods: Ten cases of mandibular defects were reconstructed with fibular myocutaneous flap, of which 7 were male, 3 were female. Preoperative design was made before serial digital guides were manufactured using 3D printing. Mandible was reconstructed with the help of serial digital guide. Image fusion technology was used to evaluate postoperative outcome. Results: No complication was found after surgery. All guides took position smoothly. Reconstruction titanium plate and condyle were in their position as designed. Ideal occlusion and facial contour were achieved. Postoperative image fusion showed <2 mm deviation between pre- and post- operative positions of residual mandible and condyle. Conclusion: Serial digital guide could be considered during mandible reconstruction, which could locate condyle position, accurately recover occlusion, and reduce operation time.