[Objective] To introduce the surgical technique and preliminary clinical results of intramedullary nailing of tibial shaft fractures via infrapatellar approach by lateral position. [Methods] A total of 103 cases of tibial shaft fracture admitted from June 2015 to September 2019 were selected. The intramedullary nail was placed in lateral decubitus via infrapatellar approach, and closed reduction, reaming and static locking techniques were used. Intraoperative fluoroscopy, number of successful cases of one-time guide wire placement, operation time, number of assistants, anterior knee pain and Lower Extremity Functional Scale (LEFs) at 12 months of follow-up were analyzed. [Results] The patients were followed up for 12-36 months. Intraoperative fluoroscopy was performed 8 to 17 times with an average of (10.80±2.43 ) times. The number of successful cases of one-time guide wire placement was 84 (81.55%). The operation time was 40-92min with an average of （72.98±14.21）min. Average number of assistants was （1.36±0.35）. At the follow-up of 12 months, 17 cases (16.50%) had anterior knee pain and the average LEFs score was (77.19±2.39）. [Conclusion] Intramedullary nailing of tibial shaft fractures via infrapatellar approach by lateral recumbent is a comfortable position. It has the advantages of convenient intraoperative fluoroscopy, shorten operation time and fewer assistants , especially suitable for the promotion at primary hospital.