Background– Extraarticular Proximal tibia fractures of tibial shaft in adults impose high challenges in the management due to high energy soft tissue injury hence Surgical treatment requires special respect for the soft tissues while taking into account the specific biomechanical properties of the proximal tibia. Objectives - To assess and compare the outcome and the clinical factors associated with the outcome of intramedullary nailing and plating in the treatment of extra-articular proximal tibial fractures. Method - prospective randomized clinical study conducted in the department of Orthopedics, SDM College of Medical Sciences,sattur,Dharwad India, from July 2019 to August 2022 Patients meeting the inclusion criteria were divided in to two operative groups of intramedullary nailing and plating using a computer generated random number, Primary & Secondary outcomes evaluated. Result – Out of 36 patients included, 13 (44.8%) underwent closed intramedullary nailing &16 (55.2%) closed plate osteosynthesis union was achieved in 34 of 36 (94.4%) patients at final follow up. 14 patients (38.9%) had malreduction. There is no significant difference in the knee society score between the nailing group and the plating group, as assessed by the Mann Whitney U test (p value=0.079). Conclusion - There are no specific indications for both treatment modality ,Even though significantly high rates of malreduction occur in intramedullary nailing compared to plate osteosynthesis there is no significant difference in the functional outcome, Intramedullary nailing and plate osteosynthesis can be used with good functional outcome in the treatment of extra-articular proximal tibia fractures.