Large talar body defects after total or subtotal talectomy present a difficult treatment dilemma for the reconstructive foot and ankle surgeon. Treatment of these defects includes tibiocalcaneal fusion, but this leaves the patient with significant limb shortening. Tibiotalocalcaneal fusion can be done if there is a subtotal talectomy with the talar head and neck remaining. This technique is done with some form of structural or cancellous graft with internal or external fixation. These fusions are technically challenging and often involve harvesting large autografts from the iliac crest. The technique described involves a less complex reproducible 1-stage reconstruction for large talar defects using a transfibular approach with placement of a femoral head allograft in a fusion bed prepared by acetabular reamers.