Morbidity following 104 bone graft harvesting operations (60 iliac, 44 rib) in 72 patients is documented. Early morbidity of iliac donor sites was found, as expected, to be far greater than that of rib donor sites. However, long-term follow-up reveals that while hip symptoms largely resolve, a significant number of chest-wall sites cause persistent, unpleasant pain. Technical ways of minimizing problems are also discussed. When procuring an iliac graft, a lateral skin incision and a medial bony approach are used if possible. If full-thickness ilium is required, the crest should be left intact or raised and replaced as a trapdoor .