Background: Defects in elbow extensors usually occur with severe trauma and more in young or middle age people. The acute injuries can be repaired by direct suturing and bone anchorage. Such a repair is not feasible in chronic cases (a few weeks old) and in massive defects often seen in patients with head injuries. Use of Achilles tendo allograft is a good repair alternative, allowing earlier motion and producing more powerful extension. We would like to report our experience with four such cases.Methods: Four cases of chronic post traumatic in triceps brachi rupture, age range of 25-49 years, were treated with Achilles tendon allograft attached to a piece of calcaneous. Progressively increasing elbow motion was started after the second week. The patients were clinically evaluated with 14 months average follow-up, using Mayo Elbow Performance Score (MEPS). Each elbow was compared with the opposite side.Results: Excellent performance scores was seen in 3, and good in one patient. Elbow range of motion was 85 percent (82-96%) of the healthy side, and elbow extension power was 80% of the normal elbow. Transient uluar neuroparaxia in one case was the only complication which recoverd fully in 3 months.Conclusions: Massive chronic post traumatic tricep brachi defects can be effectively managed by bone/tendon allograft from Achilles tendon.