Over the past two decades, pediatric orthopedists have increasingly recognized the advantages of fixation and rapid mobilization. However the risk of complications particularly re-fracture after external fixation and avascular necrosis after solid intramedullary nailing have prevented these methods from becoming adopted as the best surgical line of treatment. Aim of the work is to highlight the benefits of using titanium elastic nails for pediatric femoral shaft fracture fixation and to show failures and complications of pediatric femur fractures treated with titanium elastic nails. Titanium elastic nailing is a very simple, reliable, effective and minimally invasive method of treatment. It may prove to the ideal implant to stabilize many pediatric femoral shaft fractures in the age group between 6 and 16 years old.