ABSTRACT Background: The Benefit of the second venous anastomosis for free flap success is still controversial issue between micro-surgeons. While some studies have pointed to its valuable effect, others have refused this role. In this work, the effect of the number of venous anastomosis on the free flap success is studied. Patients and Method: This retrospective study reviews and analyzes the results of forty seven free flaps that operated by the authors through the last eight years, flaps were assigned to group A if they have single venous anastomosis and group B if they have double anastomosis. Results: The overall complication rate was 23.4%, vascular compromise occurred in 17% of cases, and failure rate was 12.7%. The incidence of venous thrombosis was 8.51% in group A and 6.38% in group B. statistical analysis of results revealed that neither second venous anastomosis nor smoking had significant effect on flap success. Conclusion: Double venous anastomosis is not recommended as guarantee against venous insufficiency.