Background:Distal femur fractures occur following high-energy impact in young patients or low-energy injury in elderly patients with osteopenic or osteoporotic bone.This study is aimed to compare the results of retrograde Nailing versus plating technique in distal femoral fractures regarding both clinical and radiological alignment. Patients and methods:This study was conducted on 18 patients with distal femoral fractureswho divided into two groups; Group A treated by retrograde femoral nail (RGN) and group B treated by Plating technique. All patients were subjected to clinical and radiological measurements to assess the outcomes after surgery. Results:Clinical measurements in normal limb was 4.66±1.32 in retrograde nail group while it was 4.88±1.58 in plating group, the MAD in fractured limp clinically was 5.38±1.89 in retrograde nail group while it was 6.48±2.31 in plating group. The radiological MAD showed significant difference between the normal and operated side. Mechanical Lateral Distal Femoral Angle (mLFDA) in fractured limb was 88.66±2.54 in retrograde nail group while it was 89.33±3.67 in plating group (P=0.663). Medial Proximal Tibial Angle (MPTA) in fractured limb was 87.77±1.85 in retrograde nail group while it was 87.88±3.48 in plating group. In spite of the excellent results in RGN group compared with group (B), the overall results showed no significant difference statistically between the two groups. Conclusions: Retrograde nailing is a good fixation system for fractures of distal femur with better outcome in terms of range of movements, less infection rate and early mobilization.