Background: Controversy exists regarding the best technique for treating displaced transverse olecranon fractures with advocates for three techniques: (1) intramedullary (IM) screw, (2) locking plate, and (3) tension band. Objectives: The aim of this study was to seek which method of fixation fits best according to olecranon fracture type and postoperative outcome. Two methods were used: K-wire with tension band and intramedullary screw. Patients and methods: A prospective randomized comparative study included 20 patients with displaced transverse or oblique fracture of the olecranon, treated at Department of Orthopedics, Sohag University Hospital. The patients were randomly divided into two groups of equal number where patients with odd numbers were treated using AO tension band wiring (Group I) and those with even numbers by intramedullary screw (Group II). Results: Patients' characteristics were insignificantly different between both groups. The range of motion was significantly higher in group II than group I. Mayo Elbow Performance score (MEPS) was significantly higher at 4 weeks, 3month and 6 months in group II compared to group I but with an insignificant difference at 2 weeks between both groups. Visual analogue score (VAS) was significantly lower at 6 months in group II compared to group I but with an insignificant difference at 2 weeks, 4weeks and 3month between both groups. Conclusion: It could be concluded that olecranon fracture fixation with intramedullary screw is superior to K-wire with tension band in transverse or oblique non comminuted fractures with more range of motion, lower VAS, and higher MEPS.