The purpose of this study is to assess the behaviour of freeze-dried cancellous allograft used for supporting the reconstructed articular surface in impacted tibial plateau fractures. Freeze-dried cancellous allograft was used as metaphyseal defect filling agent in twenty-three patients (fifteen men and eight women, mean age 53 years), who suffered impacted tibial plateau fractures. According to Schatzker classification, ten fractures were classified as type II, six as type III, three as type V and four as type VI. All fractures were treated with open reduction-internal fixation after restoration of the tibial plateau surface and insertion of freeze-dried allograft chips for subchondral support. The mean follow-up was 13 months. The clinical and radiological outcome was assessed according to the modified Rasmussen system. The freeze-dried allograft incorporated soundly in all cases within 12 weeks from surgery and no complications that could relate to the graft were recorded. Freeze-dried allograft has specific advantages in comparison to autograft or other grafts and the results of the present study justify its use in the treatment of impacted tibial plateau fractures.