Sixty-six adult patients requiring bone grafts were randomized to receive either anterior superior iliac crest (AIC) harvest (n=33) or proximal tibia (PT) harvest (n=33). The primary outcome was early donor-site morbidity, assessed as pain severity and incidence of surgical site infection (SSI). Pain was measured using the visual analogue scale (VAS) and SSI diagnosed per CDC criteria. Outcomes were evaluated on postoperative day 1, at 2 weeks, 6 weeks, and 12 weeks. Overall, the study found no statistically significant difference in SSI incidence between groups. However, pain scores were significantly higher in the AIC group on day 1 and at 2 weeks, with the most pronounced difference occurring immediately postoperatively. By 6 weeks, pain differences were not statistically significant. These findings suggest that PT harvest is associated with less early postoperative pain and similar infection rates compared with AIC harvest.