Background: Distal humerus fractures are complex and challenging injuries that require surgical intervention. The elbow joint is a complicated hinge joint which is responsible for forearm range of motion, making it essential for everyday activities such as reaching, grasping, and lifting. The most commonly used surgical approaches for treating distal humerus fractures have evolved over time, with olecranon osteotomy (OO) and triceps tongue lift (TTL). Study design: It is a comparative study conducted at the department of orthopedic surgery CMH hospital Rawalpindi for the duration of six months from 13 December 2022 to 12 June 2023. Material and Methods: The study includes 110 patients. The age of patients ranged from 20-62 years and 21-63 years in the olecranon osteotomy and triceps tongue groups respectively. There were 50 patients that went through olecranon osteotomy and 60 patients went through triceps tongue procedure. The study was approved by the ethical committee. Results: Blood loss was more in the case of the olecranon osteotomy group (250±21.2) ml and the flexion and extension after follow-up was better in the case of the triceps tongue group. Although the complication rate does not show much difference in both groups non-union, mal-union, infection site, and heterotopic ossification were much more frequently observed in the olecranon osteotomy group as compared to the TT group. Conclusion: We conclude that triceps tongue approach improves the movement and prevent excessive blood loss and less damage as compared to the olecranon osteotomy. It does improve the movement, prevent excessive blood loss and less damage as compared to the olecranon osteotomy. Keywords: Humerus, olecranon osteotomy and triceps tongue lift.