Objective To evaluate the clinical outcome and advantages of percutaneous plate fixation for complex distal tibial fractures using locking compression plate-distal tibial plate (LCP-DTP). Design This is a prospective case series study. Setting Urban, level I trauma center. Patients and methods Twenty-seven adult patients, who met the inclusion criteria, with closed traumatic distal tibia with or without fibular fractures were treated using the minimally invasive plate osteosynthesis technique with LCP-DTP. According to the AO fracture classification, there were 12 AO 43A fractures and 15 AO 43B fractures. The fibula was fractured in 15 patients and it was fixed in all of them. Main outcome measurements Perioperative complications following percutaneous fixation of the distal tibia such as infection, deformity, leg length discrepancy, ankle joint function, bony union, and metal failure within 1 year after the surgery. Results This study included 27 adult patients with traumatic fracture distal third tibia, 21 of them were men and six were were women. They were followed up for a period ranging from 14 to 19 months with an average of 16. None of the patients developed early perioperative complications. Deep venous thrombosis occurred in three patients, who were treated medically, residual loss of a few degrees of ankle motion in six and late infection related to the proximal screws was also observed in three obese uncontrolled diabetic patients. Union was achieved in all of them within 12–20 weeks with an average of 16. Conclusion Minimally invasive plate osteosynthesis for the distal tibia using the LCP-DTP is safe and effective in the treatment of complex distal tibial fractures.