Background: The patella is an important component of the extensor mechanism of the knee. Patellar fractures are relatively uncommon injuries which need to be fixed if displacement occurs more than 2 mm. Transverse fractures comprise the largest category. Patellar fractures are intra-articular fractures which need open reduction internal fixation. The aim of this work was to compare results of fixation of patellar fracture by screw and tension banding. Methods: This prospective study compared the results of treatment of 20 adults patients with transverse patellar fractures by two methods of treatment at Benha University Hospital .The patients were divided into two groups(I,II) on a random selection . Group I: including 10 patients treated with cannulated screws. Group II: including 10 patients treated with the kirschner wires and tension band wiring. Results: There was no statistically significant difference in the modified HSS score of both groups . There was no statistically significant difference relation between age, sex, side affected, occupation, mechanism of trauma and final result. There was no statistically significant difference in the modified HSS score. There was no statistically significant relation between age, sex, side affected, occupation , mechanism of trauma and final result.  The complications occurred in group I included  2 patients lost 10 degree of terminal flexion of the knee, 1  patients lost 20 degrees of terminal flexion of the knee and 1 patients lost 30 degrees of terminal flexion of the knee, while in group II, 2 patients lost 20 degrees of terminal flexion of the knee but this did not affect patient satisfaction. There were no cases with extension lag in this series, In this study, group I , 1  patients had pain due to irritative symptoms related to hardware prominence ,while in Group II  four patients had pain due to irritative symptoms related to hardware which was due to long wires. Two patients had superficial infection and in group II, three patients had superficial infection. Conclusion: There is no significant difference between cannulated screws and tension band wiring by kirschner wire for the treatment of transverse  patellar fractures according to modified  HSS score. But cannulated screws may be better in pain due to hardware irritation, while tension band is more rigid and allows early range of motion post operatively.