Objective To compare the clinical efficacy of bone transport with antibiotic bone cement combined with membrane induction in the treatment of infectious nonunion after open tibial fracture in the elderly. Methods A retrospective study was performed on 72 elderly patients with infectious nonunion after open tibial fractures who admitted to our 2 Orthopedic Departments from May 2013 to May 2016. According to the treatment, they were assigned into study group (n=36, bone transport) and control group (n=36, antibiotic bone cement combined with membrane induction). All the patients were followed up for 12 months. The contralateral alignment, bone healing index, American Knee Society (AKS) score for knee function, Baird-Jackson score of ankle function and clinical outcomes were compared between the 2 groups. The data were analyzed by SPSS statistics 19.0 software. Chi-square test or Student′s t test was used for the comparison between the 2 groups. Results There was no significant differences in age, sex and fracture location between the 2 groups (P>0.05). The study group had significantly shorter operation time [(135±17) vs (146±12)min], higher AKS score [(165.7±15.2) vs (123.7±18.1)] and Baird-Jackson score [(88.6±3.6) vs (77.6±5.4)] and lower bone healing index [(42.0±2.0) vs (43.3±3.0)d/cm], better clinical efficacy [61.1% (22/36) vs 47.2% (17/36)], and lower incidence of infection [5.6% (2/36) vs 25.0% (9/36)] when compared with the control group (all P<0.05). Conclusion Bone transport technique can promote the functional recovery in the elderly patients with infectious nonunion after open tibial fracture, and it is worthy of clinical promotion.