Although the reconstruction with tumor prosthesis is a routine procedure for extremity sarcomas, this option has some technical limitation in children under 10 years old. Customized expandable tumor prosthesis is too expensive in most cases and arthrodesis of any kind is not functional. This report presents one case of osteosarcoma of distal femur in eight years old child which was reconstructed with adult type total elbow endoprosthesis as a reconstructive option, and includes brief review of the literature.