A microvascular osteocutaneous free flap is totally detached from its origin and reattached at a distant site, in one stage, by the use of microvascular anastomosis to maintain its viability. The advantages of microvascular osteocutaneous free flap trsnsfer are more rapid healing, greater resistance to infection, less risk of absorption than conventional bone grafts, and shortened hospitalization. Two cases of microvascular osteocutaaeous free flap transfer were performed at the department of Orthopaedic surgery of Hanyang University Hospital, and satisfactory results were obtained.