Treatment of elbow bone defects is still a huge challenge in orthopaedic in order to restore the shape and function of the elbow joint. Bone defect reconstruction is very difficult due to biomechanical complexity of the elbow joint and the poor coverage tissue of this area, so mega-prothesis can be considered the most optimal solution in these cases. We present two clinical cases of megaprosthesis elbow replacement for treatment of bone defects caused by sequelae of trauma. There is one case of 3 cm bone defect at proximal ulna and one case of 3 cm bone defect at distal humerus. In the 1st case, the elbow joint is fusioned and the second case, the elbow joint is degenerated totally after 3 previous surgery. We performed total elbow replacement with a customized megaprosthesis for them. The Mayo elbow function assessment scale 1 pre-surgery was poor at 50 points. The average age is 35 years old. The mean post-operative follow-up time was 14 months. Range of elbow flexed motion was 135 degrees, both patients were maximally extension, the forearm pronation and supination were 90 and 75 degrees, respectively. The Mayo score is very good with 97,5 points. Both patients were completely satisfied with the postoperative results. Our results show that megaprosthesis elbow replacement is a very effective option for cases large elbow bone defects due to trauma sequelae. However, careful preoperative preparation is required for the best outcome. •Megaprosthesis replacement is more popular for bone tumor around elbow•Massive bone defect sequelae around elbow after trauma is really challenged to treat successfully. It will be more difficult if there is a problem with elbow joint: stiffness, degeneration, or fusion. In the past, functional arthrodesis of elbow was the main indication to resolve this problem.•With the development of 3D technology and biomaterial science, megaprosthesis is the best solution for limb preservation after bone tumor wide resection.•Application of megaprosthesis was not only limited for bone tumor, but we can also use it in some rare non-oncologic case, especially around elbow.•We introduced 2 cases with posttraumatic massive bone loss of distal humerus and proximal ulnar which are treated by. megaprosthesis successfully.