Introduction: One of the major public health concerns across the world is the fractures occurring at the distal end of radius with an incidence rate of 25.4 per 10000 elderly people who are of about 65 years of age. These fractures are the most common fractures occurring in the upper extremities of elderly patients. More than 210 million dollars are regularly spent on the management of radial fractures of the distal ends which are expected to increase every year, however, the process of managing radial distal fractures is still controversial. Aim: To compare the outcomes of surgical and non-surgical management of distal radial fractures in elderly patients. Methodology: The current study involved 90 patients who were more than 65 years of age and were treated either surgically or non-surgically. Patients who were treated non-surgically were treated with cast immobilization whereas patients who underwent surgery had either plate or external fixation. Functional scores and baseline radiographs were recorded before treatment, and follow-up was conducted at 2, 6, 12, 24, and 52 weeks. Radiographic and clinical follow-ups were observed along functional scores were calculated and observed. Results: Patients who were treated without surgery had a mean age of 76 years, whereas 44 patients who were treated with surgery had a mean age of 73 years. No significant differences were observed between the groups in terms of other demographic factors. No differences in the functional status were observed in terms of arms, hands, and shoulders whereas pain scores also exhibited no significant differences. Conclusion: It is suggested that minor limitations exist between wrist motion range and grip strength which was diminished with the non-operative care, but functional recovery was not limited during 12 months follow-up.