An overview of the spectrum and natural history of fibrous dysplasia is an essential prerequisite of management. Current medical interest has focused upon the intriguing pathogenesis of the bone lesions, the endocrinopathies, the cutaneous pigmentation, and malignant transformation. The mundane aspects of diagnosis and the complications of a soft bone disorder reside with the clinical orthopedist. Diagnosis is straightforward with the aid of biopsy. Conservatism in the surgical treatment of monostotic lesions and experience in the care of fractures and deformity in polyostotic fibrous dysplasia constitute the lessons learned in a series of over 50 patients with fibrous dysplasia.