Eight patients with bone tumor, nonunion of fracture and extensive bony defect were treated by using the technique of free vascularized fibula graft. Seven cases were successful and one case failed because of infection. Convalescence was shortened significantly. A full description of the operative procedure is presented, with a review of relevant literature and a discussion of the historical aspects of bone grafting. The vascularized bone graft is an important technical revolution in bone grafting.