Abstract:[Objective] To explore the clinical outcome of bone transport for severe traumatic tibial defect. [Methods] A retrospective study was done on 12 patients who received bone transport for severe traumatic tibial defect in our departments from May 2018 to July 2022. The perioperative and follow-up results were evaluated. [Results] All patients had the operation performed successfully without important nerve and vascular injury during the operation. The length of bone defect was of (6.9±1.2) cm, the carrying time of external fixator was of (606.3±55.2) days, with the bone healing index of (62.4±5.0) day /cm. With time of 1 month after operation, frame removed and the latest follow-up lasted for (26.3±7.5) months, the HSS score [(71.4±7.5), (85.3±5.7), (90.2±3.2), P＜0.001], AOFAS score [(70.4±4.9), (83.1± 4.4), (89.8±3.2), P＜0.001], knee extension-flexion ROM [(98.8±5.2)°, (112.6±6.0)°, (123.6±4.3)° , P＜0.001] and ankle dorsal extensionmetatarsal flexion ROM [(44.1±2.6)°, (51.4±3.3)°, (58.8±2.8)° , P＜0.001] increased significantly. The tibial length discrepancy between bilateral sides decreased significantly [(4.9±1.2) cm, (1.3±0.2) cm, (0.9±0.2) cm, P＜0.001], the tibial alignment [excellent /good/fair/poor, (8/ 4/0/0), (12/0/0/0), (12/0/0/0), P=0.009] improved significantly over time. In addition, all patients got sound bony healing at both ends of the transported bone segment at the latest follow-up. [Conclusion] Bone transport is an effective method for the treatment of severe traumatic tibial defect. Designing the transport scheme in advance, especially the distal interface, is necessary to achieve smooth healing of the interface area.