Aim: To evaluate the clinical and radiological outcome of proximal third tibia fractures managed by intramedullary nailing in knee semi-extended position via the suprapatellar approach. Methodology: Our study consists of proximal one third tibial shaft fractures which were treated with nailing via suprapatellar approach. The study was done under Rajah Muthiah Medical College and hospital, Duration of the study from May 2019 to December 2021. The patients were followed at intervals of 1 and 6 months and 1 year. Patients were observed for affect in daily day to day activities, union, shortening. The functions were assessed using Lower Extremity Functional Scale (LEFS). Results: In 20 patients of proximal 1/3rd fracture of tibia within the study with a mean follow-up of 1 year. On an average of 6-7 months the fractures united radiologically. At the top of 1 year, the typical LEFS was 86%. 4 patients had delayed union in that 1 patient had significant bone loss followed by bone grafting and transpositional gastrocnemius flap was done, one patient preoperatively had anterior skin discolouration which was debrided. Eventually all the fractures were united. There were no post-operative knee pain seen. Conclusion: Suprapatellar nailing performed with proper instrumentation, proper surgical technique is a viable option in management of proximal 1/3rd tibial fractures. Which has excellent radiological and clinical outcomes with lower complications on comparing to other management. This may be a viable option for proximal 1/3rd (extra-articular) tibia fractures thanks to its inbuilt advantages of placement, perfect nail entry and positioning