[Objective] To investigate the clinical outcomes of cannulated screw fixation of distal tibial epiphysis fracture in children. [Methods] A retrospective study was performed on 70 children who had distal tibial epiphysis fractures fixed with cannulated screws follow- ing closed or open reduction from December 2018 to December 2021, and the clinical and imaging data were evaluated. [Results] All the 70 patients were operated on successfully without complications such as vascular and nerve injury during the operation. The follow-up peri- od lasted for (8.4±2.1) months on an average. Compared with those before operation, and the VAS score at 3 months and the last time signifi- cantly decreased [(5.9±1.0) , (1.3±0.3) , (1.2±0.2) , P＜0.001] , while AOFAS score [(34.8 ±7.92) , (82.7±8.9) , (94.1±4.1) , P＜0.001] , an- kle dorsal-plantar flexion range of motion (ROM) [(36.5±4.3)°, (63.8±10.4)°, (74.9±11.5)°, P＜0.001] and inversion-eversion ROM [(30.7± 6.9)°, (54.8±8.9)°, (65.8±9.0)°, P＜0.001] significantly increased. Radiographically, the fracture alignment was significantly improved after surgery compared to before surgery (P＜0.05) , additionally, the mLDTA angle and aADTA angle significantly improved postoperatively (P＜ 0.05) . Bony healing of the fractures was observed in all patients at about 10 weeks. [Conclusion] The cannulated screw fixation is a reli- able treatment for distal tibial epiphyseal fractures in children with satisfactory short-term outcomes.