Background: The study was conducted to evaluate the role of bi-columnar plating by extensor mechanism sparing paratricipital approach in adult distal humerus trauma. Material and methods: A cohort of 20 patients presenting with distal humeral fractures underwent treatment via open reduction and internal fixation utilizing bicolumnar plating through an extensor mechanism-sparing paratricipital approach. The study participants received open reduction and internal fixation with bicolumnar plating, and intraoperative assessments were conducted to monitor blood loss, fracture reduction, and articular continuity using an image intensifier (C-arm). Postoperative follow-up occurred at one month, two months, and six months, during which clinical evaluations were performed using the Mayo Elbow Performance Score at each visit. All the results were recorded in Microsoft excel sheet and were subjected to statistical analysis using SPSS software. Results: A total of 20 patients were evaluated. Mean age of the patients was 43.5 years. Majority proportion of patients were males. On six months follow-up, excellent result was seen in 90 percent of the patients while good and fair results were seen in 5 percent of the patients each. Conclusion: The extensor mechanism-sparing paratricipital approach represents a superior alternative for addressing distal humeral fractures in adults; however, olecranon osteotomy remains the gold standard for AO type C3 fractures. This paratricipital technique effectively preserves the triceps and extensor mechanism, facilitating earlier mobilization.