Background: Proximal tibial fracture occur on the flat, top surface of the tibia, which articulates with the femur (thigh bone) to form the knee joint. The present study compared hybrid external fixation and MIPO in management of proximal tibial fracture. Materials & Methods: 94 cases of proximal tibia fracture were randomly divided into 2 groups of 47 each. Group I patients were treated with hybrid external fixation and group II with MIPO. Parameters such as location, AO classification, operative time, blood loss, hospital stay, healing time etc. were recorded. Results: Group I had 27 males and 20 females and group II had 23 males and 24 females. The etiology of fractures was road traffic accident (RTA) in 25 in group I and 31 in group II, fall in 14 in group I and 10 in group II and domestic violence in 8 in group I and 6 in group II. The difference was non- significant (P> 0.05). The mean operative time was 94.2 minutes in group I and 110.6 minutes in group II, blood loss was 120.6 ml and 205.2 ml, healing time was 9.4 weeks and 18.2 weeks, time of recovery to work was 12.6 days and 30.5 days and hospital stay was 13.1 days and 23.4 days in group I and II respectively. The difference was significant (P< 0.05). Conclusion: MIPO has been shown to be inferior to hybrid external fixation in the treatment of proximal tibia fractures. When compared to MIPO, hybrid external fixation had a lower mean operative time, blood loss, healing time, time to return to work, and hospital stay.