Starting with a review of the capabilities and main complications of external fixators, this paper shows how advances made during the past two decades have rendered the method safe, reliable, and predictable. Improved component designs, new techniques of pin care, the discovery of three basic concepts that govern the safe and effective application of pin and ring fixators, and the recognition that preoperative and long-term planning are crucial to the success of the method have made external fixation the most adaptable, versatile, and gentle method for stabilizing complex injuries of soft tissue and bone.