Background: Ankle fractures most often occur as malleolar fractures.They often need surgical treatment and have a high likelihood of not healing, these intra-articular fractures must be adequately controlled.For medial malleolus fractures, open reduction and internal fixation with malleolar screws or tension band wire(TBW) are the two main treatment techniques. Methods: The objective of this study was to compare the functional outcome of treatment by use of tension band wiring versus malleolar screw fixation for medial malleolus fracturesamong 60 patients admitted in Mahatma Gandhi Medical College & Hospital, Jaipurduring the study period of 18 months. All patients were enrolled in this study and randomized and allocated into two groups. Group A (n=30) fixation of medial malleolus using tension band wiring and Patients in Group B (n=30) fixation of medial malleolus using two malleolar screw.Patients follow up at 6th, 10th ,12th week and 6th month was done and serial x-ray evaluation and partial weight bearing with stick according to fracture pattern and stability of fixationand full weight bearing was allowed respectively. Results: The mean age of Group A was 36.00± 9.161 while in Group B was 38.33±9.297. Male and female ratios of both the groups were not statistically significant. Mode of injury, side involved andduration of hospital stay were statistically not significant in both the groups. Most common mode of injury was road traffic accidents. Conclusion: Cases managed by Tension band wiring had better functional outcome as compared to those treated by Malleolar screw.