Background: Non-unions occur in 5-10% of all fractures, whereby there is a large variability in the rate with respect to the anatomical location. All non-unions have in common that without any further medical treatment no healing can be expected, independent of the time. There is a wide range of surgical approaches for treatment of these extremely complex pathological situations, which are successful in 75-85% of the cases. Besides surgical approaches there are various conservative treatment options, which should be considered in every treatment planning. Vital non-unions sometimes shows a very good response to noninvasive procedures, particularly in the early stages., Methods and Results: Healing can be achieved even by using basic medical measures, such as optimization of comorbidities, reduction of risk factors and conditioning of an extremity. More elaborate procedures, such as low-intensity pulsed ultrasound (LIPUS) or extracorporeal shockwave therapy (EWST) can make surgical treatment superfluous in 63-94% of cases and show no or only very few side effects at a much lower cost; however, a high patient compliance level is necessary when performing these procedures. As optimal preconditions for a successful conservative treatment, non-unions should be stable due to an adequate osteosynthesis and free of infections, should not show any malalignment and the defect area should be less than 5 mm., Conclusion: In every individual case an experience physician should determine whether a conservative treatment option is possible for this complex condition.