A backward distraction osteogenesis (BDO) of the condylar segment for treatment of mandibular ramus deficiency was developed. This report describes the clinical progress of a patient with mandibular ramus deficiency in whom satisfactory occlusion was achieved and maintained by gradual posterosuperior repositioning of the displaced condyles into the glenoid fossae during intermaxillary fixation. Findings of pre- and postoperative clinical and magnetic resonance imaging indicate that the effect of BDO on the temporomandibular joint was negligible.