The majority of osteoarticular defects after tumor resection in adolescent and adult patients are reconstructed using megaendoprosthetic implants. However, even infant and pre-teen children undergo reconstruction of defects using so-called growing prostheses with an increasing frequency. Presentation of current techniques, outcomes and the most common complications of megaendoprosthetic reconstruction following tumour resection. Selective literature review and discussion of current concepts and knowledge in megaendoprosthetic reconstruction against personal experience and treatment strategies. Megaendoprosthetic reconstructions achieve good functional results and long-term limb salvage (ca.90% of cases) in adolescent and adult patients. Still, periprosthetic infection and mechanical failure of joint components are among the most common complications observed. In infant and pre-teen children treated by reconstruction using agrowing prosthesis, mandatory maintenance operations-in the process of elongating the implant-must also be considered when assessing complication risks. Megaendoprosthetic reconstructions of osteoarticular defects are astandard procedure in adolescent and adult patients. Despite asubstantial complication rate, limb salvage is achieved in amajority of patients. When using growing prostheses in younger children, one needs to be aware of additional servicing procedures that occur independently of those arising from complications.