The courses of the progression in the fibrous dysplasia are characterized by asymptomatic progression or spontaneous regression in some cases after the growth has ceased and the aims of treatment for a fibrous dysplasia are prevention of the pathologic fractures and correction of the deformities. The osteogenic potentiality of the cambium layer in the periosteum and the beneficial effect on the osteogenesis of the impregnating bone graft with autologous red marrow are well documented. We experienced an extensive fibrous dysplasia with cortical thinning and pathologic fracture and it was managed with subperiosteal combined xenograft of Kiel bone with autologous red marrow for the induction of cortical thickening and prevention of the pathologic fractures because of the inoperability of curettage due to extensive lesion over the entire femur, limitations in obtaining large amount of autogenous cancellous bone for the graft and lack of the facilities of the bone bank. This subperiosteal composite xenograft with autologous red marrow for a fibrous dysplasia gave an excellent result of a remarkable cortical thickening and we think this can be a type of management for a entensive fibrous dysplasia. So we are reporting this case with bibliographic reviews.