Distraction osteogenesis is a surgical technique originally used to lengthen the long bones without bone grafting. An osteotomy is created and by slowly separating the two segments with specially fabricated hardware, the biological distractant will grow with the bone and calcify into mature bone once the appropriate length has been achieved. Distraction techniques have been used in the human facial bone area for the past 10 years. This article reviews the basic uses of distraction osteogenesis, the pros and cons, and possible future techniques.