Purpose: The aim of this part retrospective and part prospective study was to establish the incidence of pinsite infections and assess evolution of changes in practice Methods: Data was collected retrospectively and prospectively for pin site infections from the inception of limb reconstruction service viz. 1985 to January 2002. There were 812 patients, 1042 limb segments, and 9935 pins. The various external fixators used were limb reconstruction system (LRS) 549; Ilizarov 397; Sheffield ring fixator (SRF); Dynamic axial fixator (DAF) 35; LRS/Sequoia 8; LRS/Garche 7; and Pennig 5. Results: The pin site infections were graded from 0 to 6 ( Saleh & Scott). There were no infections in 206 segments. The infection grade is shown below: We changed our pin tract care practice from 1996. We had a significant decrease in pin tract infections since then (p Conclusion: Attention to detail in insertion of wires and half pins is crucial to avoid pin site infections. This audit supports the fact that external fixation is a safe method from the point of view of infection contrary to general belief.