Distraction osteogenesis is a surgical process for reconstruction of skeletal deformities. It involves gradual, controlled displacement of surgically created fractures which results in simultaneous expansion of soft tissue and bone volume. It is the ability to reconstruct combined deficiencies in bone and soft tissue that makes this process unique and invaluable to all types of reconstructive surgeons. Gavriel Ilizarov, a Russian orthopedic surgeon, is credited with developing the armamentarium and describing the biologic basis of this process for the management of orthopedic limb deformities. The concepts described by Ilizarov have been adapted and modified for use in maxillofacial surgery. Although the majority of surgical experience with distraction technology has been in orthopedics, early results indicate the process to be equally effective in facial skeletal reconstruction. It is now possible to apply distraction technology to deformities of the jaws and dentoalveolar process. Development of miniature, internal distraction devices have made this clinically feasible and practical.