Abstract [Objective]: To compare the clinical effect of external fixator and plate internal fixation in the treatment of throwing humeral fractures. [Methods]: A retrospective analysis was performed on 60 patients with humeral projectile fracture from January 2016 to January 2020. According to doctor-patient communication results, 30 patients were treated with external fixator (external fixation group) and 30 patients were treated with plate internal fixation (internal fixation group). The preoperative general data, perioperative conditions, follow-up results and imaging data of the two groups were compared.[Results] : The rate of radial nerve injury was 1/30 in the external fixation group and 6/30 in the internal fixation group, and the difference was statistically significant (P<0.05). Incision length and intraoperative blood loss in external fixation group were significantly better than those in plate group (P<0.05). Patients in both groups were followed up for 12-18 months, with an average of 14.23 ±1.89 months. The time of active activity and full weight-bearing activity in external fixation group was significantly earlier than that in steel plate group (P<0.05). The ROM and MEPS scores of elbow extension increased significantly in both groups with the time lapse after surgery, and there was no statistical significance in ROM and constant-Murley scores of shoulder lift between the two groups at corresponding time points after surgery (P<0.05). However, ROM and MEPS scores in external fixation group were significantly better than those in internal fixation group (P<0.05). Imaging showed no significant difference in fracture reduction quality between 2 groups (P>0.05). However, the fracture healing time of external fixation group was significantly earlier than that of internal fixation group (P<0.05) .[Conclusion]: Both external fixator and internal plate fixation are better methods for the treatment of throwing humeral fractures. External fixator has the advantages of less surgical trauma, less complications and early healing of fracture.