Aim: This study reviews the re-use of implanted motorised intramedullary lengthening nails previously used for limb lengthening. Materials and methods: A retrospective review was performed on the re-use of motorised intramedullary lengthening nails. All patients had a magnetically controlled intramedullary lengthening nail in the femur, tibia, or humerus previously utilised for either lengthening or compression. Patients were included if the magnetically controlled intramedullary lengthening nail underwent attempted re-use either in the same lengthening episode or in a temporally separate lengthening treatment requiring another corticotomy. Results: Ten patients with 12 lengthening episodes were analysed including five tibial, five femoral and two humeral segments. Overall, seven of 12 nails (58%) were successfully re-deployed without the need for nail exchange. Two of three nails were successfully retracted and re-used for continued distraction in the same lengthening treatment. Five of nine nails (56%) were successfully reactivated in a subsequent, later lengthening episode. Conclusion: Re-use of a magnetically controlled limb lengthening nail is an off-label technique that may be considered for patients requiring ongoing or later lengthening of the femur, tibia or humerus. Regardless of whether the nail is used in the same lengthening episode or separate lengthening episode, surgeons should be prepared for exchange to a new implant. Clinical significance: Re-use of a magnetically controlled intramedullary lengthening nail will reduce surgical trauma and save implant cost in limb lengthening treatment but may only be possible in half of attempted cases.