Background: Upper extremity fractures, or clavicle fractures, make about 2% to 5% of all adult fractures and account for 35% to 44% of shoulder girdle fractures, making them one of the most frequent broken bones encountered in emergency rooms. The present study was conducted to compare elastic stable intramedullary nailing versus non-operative treatment of displaced midshaft clavicular fractures. Materials & Methods: 50 patients of displaced midshaft clavicular fractures of both genders were divided into 2 groups pf 25 each. Group I were treated with operative treatment with Titanium Elastic Nailing System (TENS). and group II underwent conservative treatment. Parameters such as mode of injury, side, type of fracture, and functional outcome was compared in both groups. Results: Themode of injury was RTAin 18 and 17, fall in 5 and 7 and assault in 2 and 1 in group I and II respectively. Side was right in 20and 22 and left in 15 and 13 respectively. Type of fracture was 15.2.A.3 in 16 and 12, 15.2.A.2 in 8 and 10 and 15.2.A.1 in 1 and 3 respectively. The difference was significant (P< 0.05). Functional outcome in group I and group II found to be excellent in 23 and 15, good in 2 and 6 and fair in 1 and 4 respectively. The difference was significant (P< 0.05). Conclusion: TENS found to be effective in terms of better functional outcome as compared to conservative treatment of midshaft clavicle fracture.