Autologous bone storage and reuse represent an important strategy for the repair and reconstruction of bone defects. With the increasing number of procedures such as joint arthroplasty, trauma repair, and bone tumor reconstruction, opportunities for harvesting autologous bone and its potential applications continue to expand. For patients who may require staged reconstruction, revision surgery, or bone grafting in the future, intraoperative preservation of autologous bone can reduce the need for secondary bone harvesting and improve the efficiency of bone resource utilization. However, under the frameworks of informed consent, ethical review, and regulatory requirements, standardized protocols for the procurement, processing, testing, storage, transportation, and clinical application of autologous bone remain lacking. This expert consensus was developed based on a comprehensive review of the literature, existing tissue bank regulations, and current technical standards, with reference to the American Association of Tissue Banks (AATB), YY/T 0513.1-2019, GB/T 36988-2018, and the Group Standard for Autologous Bone Tissue Banks (T/FDSA 0079-2025). It was formulated through iterative discussions and deliberations among multidisciplinary experts, taking into account the practical needs of orthopedic clinical practice in China. This consensus proposes that autologous bone storage should be integrated into a comprehensive management system covering the entire process, including preoperative evaluation, informed consent, intraoperative procurement, labeling and registration, cold-chain transportation, stratified storage, release verification, and clinical application, rather than being regarded as a single low-temperature preservation technique. At the implementation level, standardized handover procedures and cold-chain management between operating rooms and bone banks are recommended. Storage should preferably be performed under deep cryogenic conditions (−196 ℃), supported by a robust quality management system and risk contingency plans. Clinical application should differentiate among autologous use and legally compliant familial use or donation scenarios, with clearly defined indications, contraindications, screening criteria, and ethical requirements. From ethical and legal perspectives, issues including tissue ownership, informed consent, privacy protection, and disposal pathways following termination of storage should be explicitly addressed. This consensus mainly covers: (1) clinical workflows and standardized bone bank management; (2) quality control and risk management in storage and transportation; (3) safety and stability of long-term deep cryogenic storage; (4) cross-regional cold-chain transportation; (5) indications and contraindications for autologous bone storage; (6) principles of clinical application; (7) ownership and legal attributes of autologous bone tissue; (8) patient rights and privacy protection; and (9) compliant disposal following abandonment of storage. This consensus aims to provide standardized, practical, and traceable guidance for medical institutions in the procurement, storage, and clinical application of autologous bone tissue, thereby promoting safe, regulated, and legally compliant practices and advancing standardization in this field.