Objectives: This study was conducted to compare the results of tension band wiring (TBW) and Cannulated Cancellous screw (CCS) fixation for the medial malleolus (MM) fracture in bimalleolar fracture in terms of functional outcomes and range of motion of ankle. Materials and methods: This study was conducted in our tertiary care centre from june 2017 to Dec 2018 which comprised of 30 patients of which 10 were females and 20 were males. They were divided into two equal groups, group 1 in which TBW was done for MM fracture and for the other group 2, CC screw fixation was done for MM fracture. In both the conditions, lateral malleolus fracture was treated with rush nailing. The functional outcome was measured after 6 months and 1 year using the modified ankle scoring system of Olerud and Molander and Range of motion of ankle noted. Results: we used the modified ankle scoring system of Olerud and Molander for functional outcome and according to that, excellent results were achieved in 60 % and good results were achieved in 20 % in group1 patients and excellent results were achieved in 40 % and good results were achieved in 40 % in group2 patients. the mean range of motion was 20 ⁰ dorsiflexion and 35 ⁰ plantar flexion in TBW group and 15 ⁰ dorsiflexion and 30 ⁰ plantar flexion in CC Screw group. Conclusions: when compared to CC screw fixation, TBW had shown better functional outcome and range of movements in ankle making it a preferable choice for medial malleolus fracture.