Distal tibial fractures accounts for approximately 37.8% of all tibial injuries. Fractures of the distal tibia affecting all ages. Treatment of distal tibial fractures in skeletally mature patients without articular extension is challenging because of its unique anatomical characteristics of subcutaneous location with weak blood supply and proximity to the ankle joint. To compare clinical and radiological outcomes in extra articular fractures of distal tibia treated by interlocking intramedullary nails or locked plates. This study was done at Al-Helal Hospital, during the period of February 2021 to August 2021. A total of 20 patients were recruited for this study to compare ILN vs. distal tibial locked plate with open technique in fixation of extra-articular distal tibial fractures. Patients were assessed clinically using Olerud and Molander score and radiologically at 6months. The average time for union was 13.10 weeks (range, 12-16 weeks) in group A (looking intramedullary) and 16.78 weeks (range,12-24 weeks) in group B (distal tibia locked plate) malunion was found in 20% of patients in group A (looking intramedullary) and 10% of patients in group B (distal tibia locked plate). The overall results were comparable, and most patients were satisfied with the results. These results indicate that both modalities of treatment deserve a place in treating distal metaphyseal fractures of tibia. Both techniques can provide effective treatment and fixation for closed extraarticular fractures. ILN showed lower infection rate and faster time to healing but with more mal-alignment reduction. While in open reduction internal fixation technique less mal-alignment reduction could be achieved but with more infection problems and slower rate of union.