Background: Distal humeral intra-articular fractures are complex injuries requiring stable fixation for optimal functional recovery. Dual plating techniques, including parallel and perpendicular configurations, are commonly used.This study aimed to compare the clinico-radiological outcomes of parallel plating versus perpendicular plating in the surgical management of distal humeral intra-articular fractures, evaluating their effectiveness in terms of functional, radiological, and complication-related outcomes.Materials and Methods: A prospective randomized study was conducted at a tertiary care hospital on 50 patients with AO/OTA type C distal humeral intra-articular fractures, aged 20 to 65 years, presenting within one week of injury. Patients were randomly assigned to parallel plating (n=25) or perpendicular plating (n=25) groups. Surgeries were performed using a posterior midline approach with olecranon osteotomy. Functional outcomes were assessed using the Mayo Elbow Performance Score (MEPS) and Disabilities of the Arm, Shoulder, and Hand (DASH) score, while radiological union and complications were documented. Results: The mean age was 45.6 ± 10.2 years in the parallel plating group and 46.1 ± 9.8 years in the perpendicular plating group (p=0.79). The mean surgery duration was slightly shorter for parallel plating (98.4 ± 12.1 min) than for perpendicular plating (101.2 ± 11.5 min, p=0.42). Mean blood loss was 210.3 ± 35.2 mL in the parallel plating group and 220.8 ± 32.7 mL in the perpendicular plating group (p=0.37). The mean union time was 12.8 ± 2.1 weeks in the parallel plating group and 13.2 ± 2.5 weeks in the perpendicular plating group (p=0.49). The MEPS score was 84.5 ± 8.2 for parallel plating and 81.2 ± 9.0 for perpendicular plating (p=0.21). The DASH score was 18.6 ± 4.5 and 20.3 ± 5.1, respectively (p=0.33). Complications were similar, with infection (8.00% vs. 12.00%), implant failure (4.00% vs. 8.00%), heterotopic ossification (4.00% vs. 8.00%), and elbow stiffness (12.00% vs. 16.00%), with no statistically significant differences.Conclusion: Both parallel and perpendicular plating techniques provide effective fixation for distal humeral intra-articular fractures, yielding comparable functional and radiological outcomes. Although parallel plating showed a slight advantage in MEPS scores, range of motion, and fewer complications, these differences were not statistically significant. The choice of fixation technique should be based on surgeon preference and intraoperative factors, as both methods offer satisfactory clinical outcomes.