We compared the results of the Wagner method of limb-lengthening in twenty extremities (nineteen patients) with those of the Ilizarov method in twenty-one extremities (eighteen patients). The Wagner external fixator was used in all twenty procedures in which the Wagner lengthening method was performed and in fourteen procedures in which the Ilizarov lengthening method was performed. The Ilizarov external fixator was used in the remaining seven procedures in which the Ilizarov method was performed.The average increase in length was 5.4 centimeters (range, 2.8 to 8.0 centimeters) with the Wagner technique and 5.9 centimeters (range, 1.0 to 16.8 centimeters) with the Ilizarov technique. The rate for the lengthening phase was nine days for one centimeter of length with the Wagner technique and twelve days for one centimeter with the Ilizarov technique. The rate for the consolidation phase was forty-four days for one centimeter with the Wagner technique and twenty-six days for one centimeter with the Ilizarov technique.The group of patients who were managed with the Wagner technique had thirty major complications, and the group of patients who were managed with the Ilizarov technique had only thirteen major complications. Forty complications were associated with the use of the uniaxial Wagner external apparatus and sixteen, with the use of the multiaxial Ilizarov external fixator.