A modified method of tibial bone-graft harvesting is presented. A hollow, cylindric, hand-driven instrument is used to harvest the graft at the medial slope of the tibial tuberosity. Satisfactory amounts of autogenous cancellous bone graft are available to bridge osteotomy gaps and facial fractures, fill smaller defects, and even obliterate a frontal sinus. There is minimal donor-site morbidity, and complications have not been seen in a series of nine consecutive patients.