Background: Locked plating and intramedullary (IM) nailing are 2 used common modalities in treating distal tibia extra-articular fractures. Objectives: To study and compare between techniques regard outcome and complication therefore, to improve outcome of patients with displaced extra-articular distal tibia fractures. Patients and Methods: The current trial was a non-random controlled clinical trial conducted on 18 patients with tibial fracture at the Orthopedic Department, College of Medicine, Zagazig University. A total of 18 patients were divided into 2 groups of 9, with 9 patients in Group (I) receiving an intramedullary nail and 9 patients in Group (II) receiving a plate. Results: Operation duration and hospital stay were longer among plate group. Majority of both groups were excellent and good. We found that nail group has better outcome. The postoperative Teeny and Wiss score's did not differ significantly across the groups. In terms of postoperative complications, there was no significant difference between the groups. Conclusion: Both techniques can provide effective treatment and fixation for closed extra-articular fractures. Intramedullary nailing showed lower infection rate and faster time to healing but with more mal-alignment reduction.