Objective To compare the clinical effect of Ilizarov frame and unilateral frame in the treatment of tibial segmental bone defect combined  with soft tissue defect by open bone transport.  Methods A retrospective casecontrol study was conducted to analyze the clinical data of 32 patients with tibial segmental bone defect and soft tissue defectup who underwent open bone transport technique in Tianjin Hospital from August 2008 to August 2016 and obtained complete followedup. There were 22 males and 10 females, aged 22-64 years(mean,36.8 years). Nineteen patients in the Ilizarov group showed the mean bone defect length of 7.9 cm and mean soft tissue defect area of 41.4 cm². Thirteen patients in the unilateral group showed the mean bone defect length of 7.8 cm and the mean soft tissue defect area of 39.2 cm². The results of fracture healing, wound healing time, radiological consolidation index, external fixation index, Association for the Study and Application of the Method of Ilizarov (ASAMI) bone and lowerlimb function score and incidence of complications were compared between the groups.  Results All patients were followed up for 24 to 60 months［(32.6±1.3)months］. Bone healing was achieved in all patients. The wound healing time was (2.7±2.3)days in Ilizarov group and (2.4±1.8)daysin unilateral group (P>0.05). The consolidation index was (43.4±8.7)d/cm in Ilizarov group and (45.8±10.3)d/cm in unilateral group (P>0.05). The external fixation index was (52.6±8.9)d/cm in Ilizarov group and (58.7±12.9)d/cm in unilateral group (P<0.05). The results of ASAMI bone score was excellent in 10 patients, good in 6, fair in 2 and poor in 1 in Ilizarov group, with the excellent rate of 84%; and excellent in 6 patients,good in 4, fair in 2, and poor in 1 in unilateral group, with the excellent rate of 77%, with insignificant difference between two groups (P>0.05). The results of ASAMI lowerlimb function score was excellent in 8 patients, good in 7, fair in 3, poor in 1 in Ilizarov group, with the excellent rate of 79%; and excellent in 6, good in 3, fair in 3, poor in 1 in unilateral group, with the excellent rate of 69%, with insignificant difference between the two groups (P>0.05). Incidence of axial deviation was zero in Ilizarov group versus 23% in unilateral group (P<0.05). After operation, Ilizarov group had refracture in 1 patient and pin site infection in 5, and unilateral group had refracture in 1 patient and pin site infection in 1, showing no significant difference between the two groups (P>0.05).  Conclusions Tibial segmental bone defect with soft tissue defect can be effectively treated by open bone transport with Ilizarov and unilateral frame. Ilizarov frame has betterbiomechanical properties and is more convenient for correction of poor postoperative axial alignment.