Objective To introduce preliminary experiences using arthroscopic debridement and bone autografting to treat atrophy nonunion of long bone fractures, especially those with severely damaged soft tissues. Methods There were 13 patients (8 males and 5 females) with atrophy nonunion of long bone fractures, of whom seven patients were associated with severely damaged soft tissues. Under guid-ance of radiography, two portals for insertion of arthroscope were created towards the nonunion site.Then, debridement of the fracture and bone autografting were performed under arthroscope. Results The operation lasted for mean 65 minutes, with mean blood loss of 15 ml. No severe complications at the nonunion site during and after operation were found except for complications related to the iliac crest donor site. All fractures were healed, without pain, instability or loss of functional range of movements. The du-ration of fracture healing was 3-7 months (mean 5.2 months). Conclusions Arthroscopic bone auto-graphing in treatment of atrophy nonunion of long bone fractures is proved to be an minimally invasive sur-gery, with high fracture healing rate, and is especially suitable for those with severely damaged soft tis-sues.