One-stage bone reconstruction of both the maxilla and the mandible with a single bone transfer is unusual in microsurgery. The authors report and describe the surgical technique of an original one-stage bone reconstruction of the maxilla and the mandible in a defect caused by a gunshot injury. The reconstruction was performed with a free fibular osteocutaneous flap. A concomitant maxillo-mandibular defect is uncommon. Gunshot injuries and tumours are the two main causes of this defect. The reconstruction of maxillary and mandibular defects can be a surgical challenge. The reconstruction was performed in one stage with the free transfer of a fibular osteocutaneous flap. (c) 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.