Treatment of distal tibial fractures has always been challenging. Fractures of the distal third tibia are unique in that the bone is subcutaneous with depleted muscular cover; the consequent decreased vascularity leads to complications like delayed bone union, wound complications such as dehiscence and infection. Minimally invasive Percutaneous plate osteosynthesis (MIPPO) is an established technique for fixation of fractures of the distal third tibia. The aim of our study was to manage extraarticular fractures of the distal third tibia by the minimally invasive plate osteosynthesis technique and follow them prospectively. Clinical and radiological outcomes were studied and clinical indications & efficacy of the procedure reviewed.