Introduction: The incidence of high energy trauma is increasing with increase in traffic. Due to its subcutaneous anatomical location, tibia is vulnerable to direct blow in high energy trauma. Open tibial fractures are true surgical emergencies because of the risk of extensive infection to bone and devitalized soft tissue. The most serious consequence of open tibial fractures is amputation-which usually can be prevented by prompt early surgical intervention. Materials and Methods: Open tibial fractures often are the result of trauma from motor vehicle collisions, farm accidents, falls from heights, or fall of heavy objects. We studied 50 patients with compound tibia-fibula fractures for their mode and grade of injury, methods of stabilization, rate of union, rate of infection, method of soft tissue coverage used, requirement of change of implants, requirement of secondary procedures, amputation & postoperative rehabilitation. Result: Majority of the patients belonged to the age group of 41-50 years with a male preponderance and the commonest mode of injury was road traffic accidents. Bone grafting was required in 38% patients. The average time of union for the patients who required bone grating was 43 weeks and in those who didn't need was 26.12 weeks. Six patients required amputation and two patients died. Conclusion: As the Gustilo-Anderson grade increases, the chances of infection and non-union also increase and outcome is poorer. So we feel that more aggressive treatment has to be carried out for Grade III injury within first 48 hours to achieve optimum outcome.