Heterotopic ossification (HO) is a common complication following spinal cord injuries, traumatic brain injuries and burm. Although bony overgrowth has been shown to occur after acquired pediatric amputation, there are no reports linking HO to amputation in the adult population.The authors review the literature and present a case report involving the unusual finding of heterotopic ossification following traumatic transtibial amputation in an adult patient. A 50-year-old Bosnian man sustained multiple shrapnel wounds to the lower extremities due to artillery shelling at the “Bread Line Massacre” in Sarajevo during May 1992, which resulted in bilateral transtibial amputations. One year later, with the assistance of the International Organization for Migration, he was brought to the department of physical medicine and rehabilitation at the Medical University of South Carolina for prosthetic fitting and gait training.Roentgenograms revealed both residual limbs had developed heterotopic ossification that extended up to 4 cm beyond the tibia and fibula of the distal residual limbs into the subcutameous tissue. The patient was fitted with bilateral patellar tendon-bearing prostheses with Springliteadynamic response feet. Despite the presence of the extensive ossification, the patient became a successful prosthesis user and achieved independence in all activities.