Background: Many options are available to cover a palatal defect, including local or free flaps. The objective of this study was to evaluate the usefulness of palatal mucoperiosteal island flap in covering a palatal defect after tumor excision. Methods: Between October 2006 and July 2013, we identified 19 patients who underwent palatal reconstruction using a palatal mucoperiosteal island flap after tumor excision. All cases were retrospectively analyzed by defect location, size, tumor pathology, type of reconstruction, and functional outcomes. Speech and swallowing functions were evaluated using a 7-point visual analog scale (VAS) score. Results: Among the 19 patients, there were 7 men and 12 women with an age range of 25 to 74 years (mean, $52.5{pm}14.3$ years). The size of flaps was $2-16cm^2$ (mean, $9.4{pm}4.2cm^2$). Either unilateral or bilateral palatal island flaps were used depending on the size of defect. During the follow-up period (mean, $32.7{pm}21.4$ months), four patients developed a temporary oronasal fistula, which healed without subsequent operative. The donor sites were well re-epithelized. Speech and swallowing function scores were $6.63{pm}0.5$ and $6.58{pm}0.69$ on the 7-point VAS, indicating the ability to eat solid foods and communicate verbally without significant disability. Conclusion: The palatal mucoperiosteal island flap is a good reconstruction modality for palatal defects if used under appropriate indications. The complication rates and donor site morbidity are low, with good functional outcomes.