[Objective] To evaluate the clinical outcomes of mini external fixator for fresh Monteggia fracture in children. [Methods] A total of 12 children with Monteggia fractures were enrolled in this study. Intraoperative fracture reduction and external fixation with a mini frame were conducted in all the children, additionally elbow arthrography intraoperatively was used if necessary to evaluate the reduction, followed by postoperative forearm plaster cast in supination. [Results] All the children were successfully operated without related complica- tions, and were followed up for 6~12 months. The range of motion (ROM) of the elbow flexion-extension and the ROM of forearm rotation were significantly increased at the last follow-up compared with those at 4 weeks after operation (P＜0.05) . According to the Mayo elbow score at the latest follow- up, the clinical outcomes were marked as excellent in 11 cases and good in 1 case, with excellent/good rate of 100%. Radiographically, all the 12 patients achieved satisfactory recovery of humeroradial congruence and ulna alignment after surgery, which remained unchanged until the latest follow-up (P＞0.05) . The X-ray films showed callus formation at fracture site as early as 4 weeks after the operation, with sound fracture healing time on the images ranged from 8 to 12 weeks. [Conclusion] This mini external fixator is an effective treatment for fresh Monteggia fracture in children, with benefits of simplifying operation and minimizing iatrogenic trauma.