Introduction: It is generally admitted that most Distal Third Tibiafractures can be managed successfully by Close Nailing & Plate Osteosynthesis. Whenever operative treatment is required, a choice has to be made between plate osteosynthesis and intramedullary nailing. Fixation with plates requires extensive dissection and is complicated by extensive soft tissue damageand the risk of implant expose in osteopenia bones. Biomechanically intramedullary nail is a better implant. They act as load sharing devices, they do not require extensive exposurewe studied the efficacy of the Intramedullary nailing in treating distal tibialfractures among 23 patients. Materials and Method: In this study total twenty three patient of distal third tibia fracture treated with intramedullary nailing evaluated for functional and radiological outcome. Our study is retrospective and observational. We have done management and regular follow up of these patientsalong with collection of data between June 2017 to July 2019.The outcome was assessed based on fracture union, fracture alignment, range of knee and ankle movements within 1yr. Results: In our study, we observed that, there were eleven(50%) patients who had fracture united within 19-20 weeks,six (27.27%) patient had fracture union between 12 -16 weeksandone patient in which no sign of union seen at 11 month follow up. In our study we have found one case(4.35%) of deep infection after 1 year of nailing in which removal of implant done, one case (4.35%)of delayed union inwhich after 3 month dynamization done, one case (4.35%) of non-union till 9 month but patients has no difficulty in his day to day life and 3 patients (13.4%) have developed knee pain. Conclusion: Intra Medullary Tibia Nailing provides stable internal fixation, early ROM knee and ankle, provides angular stability and hence provides excellent clinical and radiological outcome.