Introduction: Distal tibia fractures are often caused by high energy axial compressive, direct bending or low energy rotation forces. These fractures constitute less than 7% of all the tibial fracture and less than 10% of all lower extremity fractures. Management of distal tibia fracture is challenging because of its subcutaneous location with precarious blood supply, proximity to the ankle joint and associated soft tissue injury. To date, locked plates, intramedullary nails and external fixation are the three most used techniques. Aim: The aim of this study is to compare clinical and radiological outcome in extra articular fractures of distal tibia treated by interlocking intramedullary nails and locking plates with reference to rate of healing, functional outcome and complications Methods: This was a prospective study conducted in Department of Orthopaedics at Government general Hospital/Medical college between August 2018 and March 2020.The study consisted of 30 consecutive patients with Extra-articular Distal tibia fracture (distance from the joint between 40 and 100mm) divided into two groups based on the mode of management surgically with either Intramedullary interlocking nailing (IMIL) group or Open reduction and internal fixation (ORIF) or Minimally invasive percutaneous plating (MIPPO) group. The Clinico-Radiological evaluation of patients was regularly followed up for a period of 1year with respect to tenderness at fracture site, abnormal mobility, infection, pain on movement of knee, ankle joints and anteroposterior and lateral radiographs of the leg with knee and ankle for union of the fracture. All patients were graded using The American Orthopedic Foot and Ankle Society (AOFAS) score11 and Functional score of Olerud and Molander12 Results: Age range of the patients was 18-65 yr. Most common mode of trauma in both the groups is Road traffic accident. Associated fibula fracture was present in 18 (90%) participants in group 1 and 17(85%) patients in group 2. Difference between 2 groups regarding duration of surgery is not significant. No significant intraoperative complications were noted in both groups In Interlocking group average time for union was 17.43 weeks compared to 21.40 weeks in plating group which was significant (p value <0.05). Also the average time required for partial and full weight bearing in the nailing group was 4.4 weeks and 9.53 weeks respectively which was significantly less (p value <0.0001) as compared to 7.07 weeks and 13.29 weeks in the plating group. Lesser complications in terms of implant irritation, ankle stiffness and infection (superficial and deep) were seen in interlocking group as compared to plating group. Malalignment was found in 25% of patients in group 1 and 10% of patients in group 2. Angulationin group 1 was 3.4 degree (range, 0-12) and 1.0 degree (range, 0-9) in group2 (p=0.04). Conclusion: Our study results indicate a superiority of IMN over LP in terms of lower rates of infections and statistically significant shorter time to full weight bearing. Whereas LP appeared to be advantageous over IMN in terms of leading to a better anatomical and fixed reductions of the fracture and a lower rate of union complications. The two treatments achieved comparable results in terms of operation time, hospital stay, union time and functional outcomes. We recommend fibular fixation whenever intramedullary nailing or locking plate fixation is used in distal tibiofibular fractures.