The aim of the study compares intramedullary nailing and plating for extra articular distal tibia fracture among 50 patients admitted in Mahatma Gandhi Medical College & Hospital, Jaipur during the study period of 12 months.Patients fulfilling the inclusion criteria were included in the study. All patients were enrolled in this study and randomized and allocated into two groups.Group A (n=25) operated with distal tibia locking plate and patients in Group B (n=25) operated with intramedullary interlocking nail.All cases of intramedullary nailing were done by closed reduction by patellar tendon splitting approach. Plating was done by Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) technique.In results, the mean age in nailing group was 46.0 ± 15.18 years whereas in plating group it was 43.0 ± 12.72 years (P>0.05). The majority of patients were males, in their fourth to fifth decade of life and road traffic accidents were the most prevalent cause of injury.The excellent and good outcomes of 25 patients operated with distal tibia locking plating, followed by 21 patients had an excellent and good outcomes operated with intramedullary nailing.In conclusion, both closed intramedullary nailing and a locked compression plate are both effective in treating fractures of distal tibia. Nailing resulted in better range of motion at ankle joint and earlier fracture healing in comparison to plating. Weight bearing can be started early with interlocking nailing. This study suggests IMN might be slightly superior in reducing postoperative complications when compared to plating, but there was no difference in functional outcomes.