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Osteofibrous dysplasia is a rare bone tumor arising in patient younger than 10 years. Because of the frequent local recurrences after intralesional curettage and even after wide extraperiosteal resection, it is difficult to treat. Recurred lesions often showed increased disease activities. We experienced a case of osteofibrous dysplasia arisen in tibia. We treated the recurrent lesion occurred after two times of curettages and bone grafts with wide extraperiosteal segmental resection and reconstruction with free vascularized fibular graft. Here we report the case with review of the related literatures.