The results of distraction histogenesis using Ilizarov techniques for 18 consecutive patients were evaluated. There were 13 male and 5 female patients. Their ages ranged from 11 to 74 years (average 36.8 years). All patients presented with established hypertrophic nonunion of the tibia, associated deformity ≥15° and leg shortening. There were no cases of active infection at the time of our treatment. The procedure included fibular osteotomy, application of a pre-constructed Ilizarov frame. Controlled distraction was done until complete deformity correction and equalization of leg length. Weight bearing was allowed during treatment. All patients (100%) had their nonunions consolidated with deformity correction and restoration of the normal mechanical axis of the limb. The leg length discrepancy was corrected in all cases. The follow up ranged from 29 to 50 months (average 37.2 month) after fixator removal. Distraction histogenesis, using Ilizarov techniques, is a reliable method for consolidation of hypertrophic nonunion, deformity correction and equalization of leg length all in one procedure through minimal surgical interference.