INTRODUCTION: Distal humerus fractures in adults comprise 2% of all fractures and 30% of all humeral fractures. Intra-articular distal humerus fractures account for 37% and involve both medial and lateral columns. Most of the distal humeral fractures in adults must be treated surgically to get better functional outcome. The aim of this study was to assess the efficacy, technical requirements, functional outcome, radiological and clinical union, and complications of distal humerus fractures treated with bicolumnar plating. MATERIALS AND METHODS: This was a prospective study of 35 cases of distal humerus fractures conducted at a tertiary care hospital, who were treated surgically with bicolumnar plating using posterior approach with transolecranon osteotomy between 2016 and 2018. The Mayo Elbow Performance Score was used for the assessment of functional outcome. RESULTS: Thirteen (37.14%) patients got excellent outcome, 17 (48.58%) got good outcome, 4 (11.42%) got fair outcome, and 1 (2.86%) got poor outcome, and the complications observed were infections, nonunion, implant failure, and elbow stiffness. Distal end radius fracture was the common association with distal humerus fracture in our study. CONCLUSION: Open reduction and internal fixation with bicolumnar plating is the treatment of choice for distal humerus fracture mainly in type B and C fractures. Fracture types, use of locking plates, stable fixation, and meticulous repair of soft tissues along with early elbow mobilization influence the final functional outcome. Bicolumnar plating provides better stability, allows early elbow range of motion, and prevents stiffness.