Autogenous bone and cartilage grafts provide the optimal material to be used in reconstruction of the skeleton. If there were an adequate supply of autogenous bone grafts of ideal size and shape, there would be no need for allograft or endoprosthetic replacements. Unfortunately, the major limitation to the use of autografts is their short supply. This is especially true when articular cartilage is needed. The other shortcoming of autogenouus grafts is the donor site morbidity, which, although modest, is of concern to the patient and, on rare occasions can lead to a significant complication. In the future, we may be able to have patients make their own autogenous bone and cartilage grafts, but for now we are limited to small corticocancellous grafts, strips of tibia or iliac crest, a rib, or the fibula. Clinically useful cartilage grafts can be obtained only from the proximal fibula or patella.