<p class="abstract"><strong>Background:</strong> Nowadays femoral fractures in children are more commonly managed with operative fixation rather than conservative treatment because of more rapid recovery and avoidance of prolonged immobilization. Our aim of study was to assess the outcome of titanium elastic nailing in femoral shaft fracture in children.</p><p class="abstract"><strong>Methods:</strong> Twenty five children in age group 5-15 years with femoral shaft fracture were stabilized with two titanium nails. Children were followed up for one year. The operative outcome was evaluated using criteria of Flynn. Complications associated with procedure were recorded and analyzed.<strong></strong></p><p class="abstract"><strong>Results:</strong> The final outcome was excellent in 67% (19 of 25) of patients, satisfactory in 16% (4 of 25) of patients and poor in 8% (2 of 25) of patients. Poor outcome was due to limb length discrepancy, pain in the knee and angular misalignment.</p><p class="abstract"><strong>Conclusions:</strong> We concluded that titanium elastic nailing is an ideal method of femoral shaft fixation in children.</p>