Mr. Yu, 19 years old, had osteolytic bone destruction of the lower tibia with significant tumor breakthrough of the bone cortex, and biopsy confirmed giant cell tumor of bone. He was treated with a large bone graft scraped from the enlarged lesion, and the bone healed after six months. At 6 years follow-up, the tumor did not recur, functioned well, and returned to normal completely. Conclusion: Grade III giant cell tumor of bone does not necessarily require resection of the tumor segment + reconstruction, and the use of expanded lesion scraping + bone grafting or bone cement filling is also a valuable option under certain conditions.