ABSTRACT Objectives: This prospective cohort study was done to evaluate the outcomes of two surgical techniques (intramedullary fixation versus plating) in the treatment of midshaft clavicle fractures. Patients and Methods: Twenty-four patients between 18 and 60 years of age were included in this study. They were divided into two groups to be treated with intramedullary nailing or plating. Clinical and radiological assessments were performed at regular intervals. Outcomes and complications of both groups were compared. Results: The union time was significantly less for the nail group. However, there was no significant difference found between the two groups regarding the functional outcome, which was based on the Quick DASH Score. Infection and nonunion were higher in the plate group, but with no significant difference between the two groups. Skin irritation (hardware prominence) was significantly higher in the nail group. On the other hand, the plate group had significantly higher rates of patient dissatisfaction due to scar formation. Conclusion: Intramedullary fixation is a safe, minimally invasive surgical technique with a lower complication rate, faster union time, excellent cosmetic, comparable functional results and can be used as an equally effective alternative to plate fixation in the treatment of the mid-shaft clavicle fractures. Keywords: Mid-shaft clavicle fracture, Intra-medullary nailing, plating.