Background: Fractures of the distal tibia are distressing because these occur mainly because of high-energy mechanisms and vehicles. The present study was conducted to compare multidirectional locked nailing and plating in the treatment of distal tibial metadiaphyseal fractures. Materials & Methods: 48 distal tibial metadiaphyseal fractures were divided into 2 groups of 24 each. In group I, all patients were managed with closed nailingand in group II, all patients were treated with the anatomically contoured locking compression plates (LCP) and screws.Parameters such as mode and nature of injury, operative time (minutes), intraoperative blood loss (ml) and fracture union time (weeks)andoutcome was recorded. Results: There were 16 males and 8 females in group I and 12 males and 12 females in group II. The mean operative time (minutes) was 80.4 in group I and 100.4 in group II, intraoperative blood loss (ml) was 54.6 in group I and 82.7 in group II, fracture union time (weeks) was 17.2 in group I and 22.3 in group II. Outcome was excellent in 20 in group I and 17 in group II, good in 2 in group I and 3 in group II, fair in 1 in group I and 2 in group II and poor in 1 in group I and 2 in group II in group II. The difference was significant (P< 0.05). Conclusion: Expert tibial nailing produced better treatment outcomes than distal tibial plating when treating patients with distal tibial metadiaphyseal fractures.