Abstract There have been many types of bone-grafting operation dealing with the congenital pseudarthrosis of the tibia (CPAT), but the failure rate is fairly high. Since 1990, 2 children with CPAT, who had received repeated bone-grafting operation in failure, were treatedaccordingto the Ilizarovs theory and its related technique. The essentials of the operation were: (1) Thorough resection of abnormal bone tissues at pseudarthrosis might freshen the ends of the bone and facilitate bone union. (2) The firm fixation and constant compression force to the bone ends might promote bone healing. (3) The tibial lengthening was performed by osteotomy at the upper tibia. The pseudarthrosis was united in 2～3 months after operation. The patients were followed up from 1 to 3 years, and it was found that the remodelling of thebone was good, no recurrence occured. The advantages were: (1) The bone grafting was no longer necessary. (2) It could give a chance to equalizethe limb length. (3) It could enable early weight bearing and functional exercise.