Tissue expansion has emerged recently as an alternative reconstructive procedure and has been used for the treatment of a variety of defects. This paper presents our experience with the use of tissue expansion exclusively for the treatment of secondary burn defects. The technique was used in 22 consecutive patients. The technical aspects of the procedure are described. The advantages of tissue expansion, including the superior quality of reconstruction, cost effectiveness, and absence of donor site scar are presented. The disadvantages, including the need for two stages, multiple office visits, its application for relatively small defects, and the objectionable temporary appearance, are discussed. Finally, patient selection, and refinements of the technique and tailoring of the expanded flaps to achieve the best possible reconstructive and esthetic results and limit the possibility of complications are discussed.