This study aimed at evaluating an innovative immediate mandibular segmental reconstructive option using patient specific titanium devices versus conventional autogenous reconstructive technique. A total of 10 patients, 6 males and 4 females with average age 26.4 (range15-45) were treated in this study. Patients were divided randomly and equally into two groups each consisted of 5 patients both received immediate segmental mandibular reconstruction. The first group (control group) underwent immediate segmental reconstruction using autogenous anterior iliac bone grafts while the second group (study group) underwent immediate reconstruction using patient specific titanium devices. A follow up period ranges from 9 to 20 months was performed both clinically and radiographically for both groups.From the results of this study we can concluded that the use of pre operative maxillofacial surgery planning software and three-dimensional modelling techniques proved to be promising and accurate in mandibular reconstructive surgeries. The idea of mirror-imaging the normal side resulted in restoration of normal facial contours for both groups. autogenous reconstruction using cortico cancellous iliac block bone grafts could be used successfully for immediate segmental mandibular reconstruction after benign tumors ablation. Electron Beam Melting Technology (EBM) is a highly accurate and promising manufacturing technique for fabrication of patient specific custom implants with predictable mechanical properties. The computer-generated templates showed an excellent fit and accurate guidance during the procedure. In the study group, all the devices were intimately fitted to the bony resection margins as planned preoperatively, and the anterior and posterior device arms were passively adapted on proximal and distal bony stumps. Patient specific titanium devices for mandibular reconstruction appear to be promising less morbid alternative to other established techniques due to: Excellent restoration of facial symmetry and contour, decreased the intra-operative time, decrease the overall treatment time and cost, as a single surgical procedure is enough to reach the goal. No donor site morbidity as that of the control group. Allow 3 dimensional reconstruction of the mandibular segmental defect. Solved the problem of the increased inter-arch space before the prosthetic loading if compared to that of the control group.