Aim: The aim of this study was to evaluate the outcome of antibiotic-coated intramedullary locking nail in the open tibia fractures. Materials and Methods: This clinic-observational study was carried out in the Department of Orthopaedics, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India for 18 months. Total 80 patients were treated with gentamicin coated tibia interlocking nail. Radiological Union was assessed using RUST Score. Result: out of 80 patients 46.25% between 26-40 years of age, 28.75% of the patients between 41-55 years of age and 16.5% above 55years and 8.75% of patients below 25 years. Males were 75% against females 25%. Time taken in wound healing in majority of patients was less than 6 weeks 42 (52.5%), 6-8 weeks 26(32.5%), 8-10 weeks 7(8.75%) and those were not healed 5(6.25%) . Majority of patents (56.25%) had RUST score 9 at six months of duration, 22.5% of patients had RUST score 11 and 8.75% patients RUST score was 6 at six months. Conclusion: Implant related infection pose an important challenge in the surgical treatment of tibia shaft fracture. Local administration of antibiotics might minimize the risk of infection.