Tibial shaft fractures are treated surgically by different methods. In the last few years interlocking intramedullary nailing has emerged as a gold standard for tibia shaft fracture. The clinical and radiological outcome is better and the complications like compartment syndrome, neurovascular injuries, infection, non-union are relatively less for interlocking intramedullary nailing of tibia. The use of ILIM nail also shows the reduce risk of reoperation. Nail is considered better as it is a load sharing device, it also neutralises both axial and torsional deforming forces. Other contributory factors for the better and natural process of bone healing in case of nail is that closed intramedullary nailing leads to minimum injuries of soft tissue, neurovascular structures and hematoma at fracture site. The nail is also locked at proximal and distal fragments which decreases the prevalence of mal-union of comminuted fractures. One distinct advantage in patients treated with interlocking nailing is their early return to weight bearing and work.