[Objective] Interlocking intramedullary nail and plate were used to treat multi-segmental fractures of the tibial , and their clinical effects were compared. [Mehtods] A retrospective analysis was made of 39 cases of multiple tibial fractures treated surgically in our hospital from January 2013 to December 2017. The patients were divided into interlocking intramedullary nail group (21 cases) and plate group (18 cases).The operation time, intraoperative bleeding volume, postoperative drainage volume, fracture healing time and complications were recorded.At the last follow-up, the function of the patients was evaluated according to Johner-Wruhs criteria for evaluating the efficacy of tibial shaft fractures. [Results] All patients were followed up for 11 to 22 months (average 13.6 months).In terms of operation time and bleeding volume, the intramedullary nail fixation group was significantly shorter than the plate fixation group (P < 0.05).There was no significant difference in drainage volume and fracture healing time between the two groups.At the last follow-up, according to Johner-Wruhs score, the excellent and good rate of intramedullary nailing group was higher than that of plate fixation group. [Conclusion] For multi-segment tibial fractures, both surgical methods can achieve good clinical efficacy.However, intramedullary nails can bear weight earlier and the incidence of complications is lower.