Seventy-five patients with bone infection have been treated at The University of Texas Medical Branch at Galveston (UTMB) with the Ilizarov external fixator. Multiple deformities were present in many patients. Thirty-four patients had infected nonunions, 22 were short, 18 were angulated, 15 needed joint fusions, 12 had open fractures, 10 had segmental defects, 5 had knee problems and equinus deformities, 4 had rotational problems, 2 had hip problems, and 1 had a translational problem. The average number of deformities per patient was 1.71. Problems with the device include length of therapy (6.8 months average time in device), pin tract infection (superficial, 41.3%; deep, 2.7%), pain (narcotic use, 2.7 months average), and device adjustment. Successful results were obtained in a high percentage of cases. The infection was arrested in 92.0% of the patients and the deformities were corrected in 85.1%. We found that the Ilizarov fixator was effective in the reconstruction of difficult deformities that result from osteomyelitis.