Background: The current study aimed at determining the clinical effectiveness and safety of Ilizarov external fixation on the treatment of femoral supracondylar fracture. Methods: The current retrospective case series study was conducted on patients with femoral supracondylar fracture. The patients were treated by Ilizarov technique and followed up for 1 - 6 years. The complication rate was determined by knee society score (KSS) and functional knee score (FKS). Results: Most of the 47 assessed patients were in the age range of 31 - 40 years (38.3%) and 83% of them were male. Average fixation time was 4.82 ± 0.96 months (range three to seven months); 40 cases (84.5%) until five months and all patients until seven months post-operation achieved complete union without major complications. The mean range of extension lack and flexion of the knee at the final follow-up were 1.91 ± 3.54 and 121.17 ± 14.45 degrees, respectively. The means of KSS and FKS at final follow-up were 90.8 ± 7.2 and 90.57 ± 8.16, respectively. Although superficial pin-tract infection was observed in 28 pin sites (59.6%), no patient developed deep infection or osteomyelitis. Conclusions: The Ilizarov fixative technique can be used as an effective and available method with low complications to treat severe femoral supracondylar fractures.