The Ender nail is used as a valuable method in treating tibial shaft fracture because of the merit, including relatively simple procedure and allowing early weight bearing and decreased complications. Also, the indications of nailing in tibial fractures have been gradually expanded to include tibial fractures involving 7.5cm distal to the tibial plateau and 5cm proximal to the tibial plafond, even segmental fractures, and comminuted fractures. Forty-eight patients with tibial shaft fractures were treated using Ender nailing at the Department of Orthopaedic Surgery, Maryknoll Hospital from March 1988 to April 1991. The cases were analyzed after minimum 1 year follow-up. The results were summarized as follows; 1. Among the 48 patients, average age was 37.6 years and 35 cases were male, and the most common cause of injury was traffic accident. 2. 36 cases (75%) were closed fractures and 12 cases (25%) were open fractures (Type I -5 cases, Type II -6 cases, Type III A-1 case), and the most common site of fracture was middle one-third. 3. Average interval from injury to operation was 8.1 days and 18 cases had associated injuries. 4. The mean duration of the radiologic bone union was 19.8 weeks. 5. Complications include 3 cases of delayed union, 3 cases of nonunion, 2 cases of proximal migration of Ender nail, 2 cases of superficial wound infection, and 1 case of anterior angulation.