Background: Supracondylar fracture constitute 60–65% of all the fractures around the elbow joint, classified according modified Gartland's criteria. The closed reduction and percutaneous pin fixation is the most widely accepted method of treatment, but controversy continues regarding the pin fixation techniques. Aim of the study: to evaluation of percutaneous pinning techniques in the management of displaced supracondylar humeral fractures Gartland type II, III. Material and method: A prospective analysis of 30 patients admitted in Orthopedic Department of Zagazig university hospital in the period between Jan 2019 and Jul 2019. The type II was affected in 24 patients and type III 6 patients, were randomized into two groups—lateral pin fixation (n = 24) and medial–lateral pin fixation (n = 6) , all of patients Primary assessment was performed for major loss of reduction, vascular and iatrogenic ulnar nerve injury. The patients were assed clinically by Flynn criteria post-operatively. Results: regarding Flynn criteria, (86.7%) had satisfactory (excellent and good) and (13.3%) had Unsatisfactory (fair and poor). Regarding complications, no case of vascular or Cubits Varus, Pin tract infection was (13.3%) and Ulnar nerve injury (10.0%). Unsatisfactory group was significantly associated with associated injuries and significantly associated with displacement and pin tract infection also with ulnar nerve injury. Conclusions: Closed reduction and percutaneous K-wire fixation is a safe, minimally invasive, rapid, and a reliable method for treatment of unstable type II, III Gartland supracondylar fractures in children with less or minimal complication.