[Objective] To compare the clinical results of two fixations for displaced proximal humeral fractures in children and adoles- cent. [Methods] A retrospective study was conducted on 71 patients who underwent surgical treatment for remarkably displaced proximal humeral fractures in our hospital between August 2010 and May 2018. According to consequences of preoperative patient-surgeon commu- nication, 34 patients received closed reduction and percutaneous Kirschner wire fixation (the K-wire group) , while the remaining 37 pa- tients had closed reduction and internal fixation with elastic stable intramedullary nail performed (the ESIN group) . The preoperative, fol- low-up and radiographic documentations were analyzed and compared between the two groups. [Results] All patients in both groups had surgical procedures finished smoothly without serious complications, such as neurovascular injury. The K-wire group was significantly su- perior to the ESIN group in terms of operation time and incision length (P＜0.05) . All patients in both groups achieved bony union without malunion and premature epiphyseal closure. At 3 months postoperatively and the latest follow-up, no significant differences were seen be- tween the two groups in terms of forward flexion range of motion (ROM) of the shoulder, Constant-Murley score and Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) (P＞0.05) . With respect to radiographic evaluation, there were no significant differences in the fracture reduction quality and fracture healing time between the two groups (P＞0.05) . The humeral neck-shaft angle significantly improved postoperatively compared with that preoperatively in both groups (P＜0.05) , but no a significant difference was noted between the two groups at any matching time point (P＞0.05) . [Conclusions] Both K-wire and ESIN are effective for treating considerably displaced proxi- mal humeral fractures in children and adolescents, with comparable clinical outcomes.