Management of tibiodiaphysial fractures in the age group of 5-15 years is controversial ,there has been a resurgence world wide for operative fixation in general and TENS(titanium elastic nailing system) in particular. We performed a retrospective review of pediatric tibial fractures treated by TENS. The data was collected from cases operated between 2010 and 2014 at Al Assad university hospital ,Lattakia. We had treated 34 children (boys and girls) with TENS for tibial shaft fractures. Average load of age was 11 years(range 5-15 years).All fractures were radiographically united at a mean of 7,5 weeks (range 5-10) weeks.The nails were removed mean of 22 weeks (range 6-31 weeks) postoperatively. At follow up we had found leg length discrepancy of 1 cm in one child and 10 degrees of internal rotational deformity in another. No angular deformity had occured.Titanium elastic nailing seems to be a safe and effective method for treatment of tibial shaft fractures in childreen between 5 and 15 years of age.