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During last 22 years the different reports have shown successful using of vascularized single fibular transplant for a simultaneous bilateral segmental mandibular reconstruction. The surgeries were performed in cases of bilateral mandibular defects of different origin: 1) bilateral infected pseudoarthrosis, 2) bilateral squamous cell carcinoma of the mandible, 3) bilateral ossifying fibroma, 4) osteoradionecrosis that caused mandibular defects, and 5) traumatic mandibular defects. We present a case of a 60-year-old patient who was referred to our clinic with osteoradionecrosis of bilateral mandible, which was reconstructed using a single fibula flap. A 6-month follow-up images are presented.