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Objective. To evaluate the outcome of TEN for the treatment of fracture of shaft of femur in pediatric age group. Method. 140 patients with diaphyseal femoral fracture were treated with retrograde Titanium elastic nail the age group 6-14 years. Two nails with same diameter were used in each fracture. The final result were evaluated using the criteria of Flynn et al. Results. The results were 102 (72.8%) excellent, 34 (24.2%) good, and 6 (3%) poor. Using the criteria of Flynn et al. All fractures were radiographically united at a median of 9 (6-11) w. The nails were removed after a median of 12 M postoperatively. The most common complication was irritation at nail insertion. Conclusion. TEN is an reliable, safe, and cost-effective implant for pediatric femoral fracture and it is an economic synthesis. It is relatively free of complication.