Cosmetic limb lengthening surgery is a procedure performed for aesthetic or psychosocial reasons without medical necessity. Based on the principle of distraction osteogenesis, this method was originally developed for the treatment of congenital or acquired deformities and limb length discrepancies, but it has increasingly been applied for cosmetic purposes in recent years. This review discusses the definition of cosmetic limb lengthening, surgical techniques, patient selection, postoperative management, and potential complications. Furthermore, the psychological factors that motivate individuals to undergo this procedure and the ethical aspects of the surgery are addressed.