Background: Floating knee is a flail knee joint resulting from fractures of the shafts or adjacent metaphyses of the femur and ipsilateral tibia. Floating knee injuries may include a combination of diaphyseal, metaphyseal, and intra-articular fractures. Objective: The purpose of this study was to evaluate the radiological and clinical outcome of minimally invasive osteosynthesis in ipsilateral fracture of femur and Tibia (floating knee) type 1 and type 2 injuries. Patients and Methods: This is one-arm clinical trial conducted at Orthopedic Surgery Department, Zagazig University Hospital during the period from March 2021 to March 2022. This study included 18 patients with floating knee injury treated by minimally invasive osteosynthesis. Results: This study showed that 6 patients (33.3%) had complications, distributed as follow; 11.1% of patients suffered from superficial skin infection, 11.1% of patients had knee stiffness, and 11.1% presented with delayed union.  Of the studied patients 5 (27.8%), 7(38.9%), 4(22.2%) and 2(11.1%) had excellent, good, fair, poor outcome according to Karistrom score, respectively. Conclusion: Minimally invasive osteosynthesis in ipsilateral fracture of femur and tibia achieves excellent clinical and functional outcomes. Individualized planning of treatment which is dependent on the patient's general condition, type of fracture, and severity of soft tissue injury by an experienced multidisciplinary team is needed, instead of a fixed definite management for all patients.