The authors present successful results surgical treatment of 18 patients with defects of mandible with exarticulation in the remporomandibular joint. For the purpose of diagnosis in the preoperanive period and after the intervention, the following methods were used: study of hemogram, orthopantomography, X-ray computed tomography, contrast angiography, laser dopplerography, production of a surgical template – the missing part of the lower jaw and study of diagnostic models of the jaws. Patricular attention is paid to careful preparation of the recipient zone and modeling of a composite fibula autograft. Revascularized metatarsophalangeal autografts of the second toe and fibula were used. To restore the function of the temporomandibular joint, titanium endoprostheses of the condylar process or unaffected head of the mandible of the patient himself were used. In 2 patients, for subsequent orthopedic rehabilitation at the same time, dental implants were installed in autografts of the fibula. To assess the effectiveness of surgical treatment, the restoration of the function of chewing, swallowing, speech, the symmetry of facial contours and the absence of disturbances from the donor area were taken into account. The use of these methods of surgical treatment of patients with end defects of the lower jaw of varios lengts and genesis is recommended. In all cases good treatment results were obtained.