Aims: Our objectives is to evaluate the functional outcome of tibial nailing in 29 patients operated at the South Birmingham Trauma unit in the period between 1992–1996. Methods: This is a retrospective study; all patients included had a tibial nail inserted for two or more years. Assessment was made by reviewing the notes, interviewing and examining the patients. A pro-forma was for each patient was collected covering various activities and outcomes. Results: The results showed that the majority of patients demonstrated a compromised activity level, both in their leisure activity and occupation. No statistical difference was observed between reamed and unreamed nails in their functional outcome measurements. Conclusions: Our conclusion that the functional outcome of tibial nailing is not as good as the anatomical restoration would predicts.