Background: The goal of treatment of displaced fractures of the anterior tibial spine is the early anatomic reduction and stable fixation for early mobilization and return to activity with minimal complications. Many methods for the treatment of this fracture have been described. The goal of this study, to evaluate the arthroscopic suture fixation technique using fiber wire for the treatment of displaced fractures of the anterior tibial spine. Patients & Methods: A prospective study of 12 patients with a tibial spine fracture had been treated by arthroscopic suture fixation technique using fiber wire. All cases had been done in Zagazig university hospital between May 2014 and April 2017. Three patients were Type 2 fracture and 9 patients were Type 3 fracture (according to Meyers - Mckeever, Zaricznyj classification), with a mean age of 13.3 years (range 10 to 15 years), The mean follow-up period was 22.5 months. Clinical outcomes were evaluated by Anteroposterior laxity tests, knee range of motion (active and passive), knee function was evaluated by the Lysholm and IKDC scores, and the activity level before the injury and at follow-up is rated by the Tegner scale. Radiological outcomes including nonunion and malposition of the avulsed fragment and physeal growth disturbance were evaluated. Results: Radiographic study showed healing all fractures at an average duration of 3.6 months after the operation. At the final follow-up, all patients reported no symptoms of instability, such as giving – way, clinical signs of ACL deficiency were not present. Two patients had 3° of extension loss, and 1 patient lost greater than 10° of knee flexion. The mean Lysholm score was 87.4 (range 87-100), mean IKDC score was 89 (range 82-94). Conclusion: Arthroscopic suture fixation technique using fiber wire for tibial spine avulsion fracture in adolescent patients has the advantage of rigid fixation, good postoperative functional outcome, and no need for hardware removal.