Congenital pseudarthrosis of the tibia is a rare and challenging condition. It occurs in 1 in 150,000 children. The aetiology of congenital pseudarthrosis of the tibia is controversial. Its association with neurofibromatosis type I has been well described. There is anterolateral bowing of the tibia at its distal third with non-union. Usually, the disease is unilateral. Bilateral occurrence is very rare. The author has successfully managed a case of bilateral congenital pseudarthroses of the tibiae treated with onlay paternal fibular graft and a long follow-up of 55 years.