Aim: A clinical study on Titanium elastic nail system in the treatment of diaphyseal tibial fracture in pediatric age group. Material and methods: A total of 50pediatric patients with diaphyseal tibial fractures were enrolled in the study. Pediatric patients aged between 5 and 16 years, patients diagnosed with diaphyseal tibial fractures confirmed by radiographic evidence, patients eligible for surgical intervention using TENS and those who provided written informed consent were included in the study. The primary outcome measure was the rate of fracture union, defined as the presence of bridging callus on radiographs and the absence of pain or tenderness at the fracture site. Secondary outcome measures such as functional outcome(PODCI scores), infection, nail migration, refracture, time to union and length of hospital stay were assessed. Results: The average scores in various categories were: Upper Extremity and Physical Function at 85.4, Transfer and Basic Mobility at 90.2, Sports and Physical Function at 82.1, Pain and Comfort at 78.5, and Happiness at 88.7. These results indicate generally positive functional outcomes post-treatment, with the highest score in Transfer and Basic Mobility and the lowest in Pain and Comfort.The study recorded several complications, including 1 case (2%) of infection, 3 cases (6%) of nail migration, and 1 case (2%) of refracture. These complications underscore the importance of careful monitoring and management during and after the use of TENS.The time to union, which was measured from the day of surgery to the confirmation of clinical and radiological union, varied among patients. Specifically, 10 patients (20%) achieved union in less than 8 weeks, 30 patients (60%) between 8-12 weeks, and 8 patients (16%) in more than 12 weeks. There were 2 cases (4%) of non-union. The majority of patients (60%) achieved union within 8 to 12 weeks, indicating a relatively quick recovery period for most. Conclusion: In conclusion, the results of this study demonstrate that TENS is an effective and safe method for managing diaphyseal tibial fractures in pediatric patients, with favorablehematological and clinical outcomes. The findings are consistent with established literature and provide further evidence supporting the use of TENS in pediatricorthopedic surgery.