Vascularized Fibula Flap is a technique that can be used in the lower extremity when there is an intercalary bone defect of critical size which means the defect size is larger than 6 cm. It is one-step procedure, has a short union time, is resistant to compression and bending forces, undergoes hypertrophy, and does not undergo resorption. However, this technique has its own disadvantages, like demanding and detailed surgery, and requires microsurgical experience. But it should be kept in mind that vascularized fibula flap has some specific own problems in the lower extremity in terms of weight-bearing issue, and unfortunately, it is not a straightforward technique as in upper extremity. Other techniques have been evolved recently such as acute bone shortening, distraction osteogenesis, non-vascularized bone grafts used in induced membrane technique (Masquelet technique), bone morphogenetic proteins, and combined approaches. Whatever is done, reconstruction of lower extremity segmental defect is a long process that requires patience in term of the patient and the surgeon.