Background: Traumatic sternal fractures are not uncommon injuries primarily caused by blunt chest trauma, such as motor vehicle accidents. Optimal management strategies for these fractures, including conservative management and internal fixation, remain a subject of clinical interest due to limited evidence. Objective: This study aimed to provide clear overview of our experience in management of sternal fracture and to evaluate the clinical outcomes, complications, and efficacy of internal fixation versus conservative management for sternal fractures at a single-center thoracic surgery unit. Patients and methods: A retrospective analysis of 28 patients treated for sternal fractures through the period from January 2019 to December 2023. Of the 28 patients, 7 underwent internal fixation using plates and screws, and 21 were managed conservatively. Data collected included demographic characteristics, intervention details, length of hospital and ICU stays, complications, and mortality. Results: The mean age was 32.8 years, with 89.3% being male. Motor vehicle accidents were the primary trauma mechanism (67.9%). Internal fixation was successful in all 7 cases, with no hardware failures or plate removals. Conservative management was applied to 75% of the patients and resulted in shorter ICU (4.2 days vs. 6.0 days; p = 0.002) and hospital stays (8.1 days vs. 14.9 days; p < 0.001) compared to the surgical group. Complications included one case of wound seroma in the fixation group (14.3%) and one case each of pulmonary infection and deformed healing in the conservative group (4.8%). No mortality was reported. Conclusion: Both internal fixation and conservative management demonstrated favorable outcomes in the treatment of sternal fractures. Conservative management remains the preferred approach for uncomplicated cases, while internal fixation is effective in selected patients. The absence of mortality highlights the importance of tailored management strategies and careful patient selection. Future research should explore long-term outcomes and standardize treatment guidelines.