Femoral shaft fractures are among the most prevalent fractures of the lower extremities in children. Although many approaches and options are available for their treatment, the most appropriate treatment option for school going children is still debatable. In this study 34 children with femoral fractures were recruited between Jan. 2018 and Jan 2019 at the Nangarhar university and public health Hospital. which is divided into two groups: (Group-A) immediate reduction with hip Spica consists 22 children and (Group -B) treatment consist of skin traction for 2-3 weeks precede with hip Spica casting consists 12 children and we studied gender distribution, fracture side, site and type of the fracture, also we note complications include; initial shortening, axial, sagittal and rotational alignment and hospital stay. All patients were under observation for a period of 3 months after removal of Spica cast. The study found that boys were more affected than girls, which the middle third of the femoral shaft was the most common site fracture (58.92%), that the spiral fracture was the most common type of femoral shaft fracture (43.18%), as well as that side way alignment was observed more than other kinds of complications in both treatment modalities; for immediate Spica, four children (18.18%) and three cases (25%).Conclusions: There was minimal difference between early and delayed Spica in terms of treatment complications and functional result. However, early Spica greatly reduced hospitalization time and treatment costs while producing equivalent results as delayed Spica use.