Introduction: Limb lengthening procedures are performed to correct significant length discrepancies, in the upper or lower extremities, that have resulted from various congenital or acquired abnormalities. The issue of limb lengthening was introduced in orthopedic surgery in the year 1950 and has been practiced up to the present time. This study comprises an analysis of bone regeneration, especially the response of bone, periosteum and endosteum to distraction limb lengthening. Materials and Methods: This study involves all patients in a tertiary care teaching hospital from January 2010 to July 2015, where bone regenerate as been produced by Ilizarov methods. 131 regenerates have been analyzed. Ilizarov external fixator was applied, and corticotomy was done. Distraction was started at a rate of 1 mm/day after the latent period (7-10 days). X-rays were taken at intervals of 1 month. Occasionally, ultrasonography was used to assess the early regenerate. Results: There were 105 normotrophic regenerate, 14 hypertrophic regenerate, and 14 hypotrophic regenerate. The lengthening achieved ranged between 3 cm and 23 cm. The average increase in length was 6.4 cm. The incidence of major complications, in our study, was 30.1%, and overall complication was 60%. Conclusion: Ilizarov external fixator is used in limb lengthening, deformity correction, and segmental long bone defect reconstruction. In our study, we achieved good to excellent results in 90% of our cases which is at par with many other studies. We achieved 10.7% excellent, 81.7% good, and 7.6% poor results. We had good to excellent or better results in the upper tibial metaphyseal area compared to any other area.