The Ilizarov method for limb lengthening and reshaping is based on sound clinical investigation and animal laboratory studies. Although new to this country, it has been used successfully in the Soviet Union for 35 years. As with all new procedures, one must learn the technique and become familiar with the apparatus before attempting to perform the surgery. Three case histories are presented which were among the first in the United States to be treated by the application of the Ilizarov technique and external fixator.