Treatment of large segmental defect of tibia is difficult because of associated infection, shortening of limb, nonunion and soft tissue reconstruction. There has been a few options for the reconstruction of segmental tibial defect including vascularized or nonvascularized fibular graft, vascularized iliac bone graft, compression-distraction osteosynthesis and allograft. Tibialization of the ipsilateral fibula for 5 patients who had large tibial defect was successfully achieved by fibular transposition using Ilizarov apparatus at our hosipital . The average defect of tibia was 10.4cm in length. The average time of Ilizarov fixation was 10.3 months. Although one patient required bone grafts, most of them achieved good bony union. The clinical and radiological features and their results were also addressed. Fibular transposition using Ilizarov may be a satisfactory method of treatment for the large segmental tibial defect associated with severe soft tissue injury or vascular compromise.