Background:A tibial plateau fracture is a type of fracture that occurs in the upper part of the tibia (shinbone), near the knee joint. The present study was conducted to compare buttress plates and cancellous screws in the management of tibia plateau fracture. Materials & Methods:72 cases of tibia plateau fractures of both genderswere divided into 2 groups of 36 each. Group I patients were treated with open reduction andinternal fixation (ORIF) with buttress plate and group II patients were treated with cancellous screws. Parameters such as type of fractures, hospital stay(days), time of union(months), and outcome were compared. Results: Group I had 20 males were and 16 females and group II had 18 males and 18 females. The hospital stay was 9.3days in group I and 5.2days in group II. The mean time of union was 4.1months in group I and 3.6months in group II. Pain (VAS) was 5.8 in group I and 2.4 in group II. Follow- up was 12.4months in group I and 8.2months in group II. The difference was significant (P< 0.05).Type of fracture was type I in 6 and 5, type II in 14 and 12, type III in 2 and 3, type IVin 3 and 5, type V in 10 and 8, type VI in 1 and 3 patients in group I and II respectively. Outcomewas excellent in 15 and 21, good in 10 and 9, fair in 7 and 5 and poor in 4 and 1 patients in group I and II respectively. Conclusion: Cancellous screws in the management of tibia plateau fracture were found to be effective as compared to buttress plates.