Background: In children, femoral shaft fractures are often treated using elastic stable intramedullary nailing (ESIN). Objective: To evaluate the functional as well as clinical outcomes of ESIN for femoral fractures in children aged 4-11 years. Patients and Methods: At Orthopedic Surgery Department of Zagazig General Hospital 18 cases diagnosed as pediatric femoral fractures were stabilized using flexible intramedullary nailing. Results: Skin irritation due to nail endings was the most prevalent consequence and was seen in 7 patients. Other complications were superficial infection (n=2), limb length inequility (n=2) and varus angulation (n=1). At 3 months follow-up, all patients had complete range of motion in their hips and knees; three patients (27.77%) had slight restriction in knee flexion, but this was recovered by 6 months follow-up. Excellent Flynn elastic nail scoring results were demonstrated in 72.22%, satisfactory results in 27.77% and none of the patients showed poor results. Conclusion: Flexible Intramedullary Nailing resulted in the best possible functional and radiological outcomes for patients with femoral shaft fractures and is a safe treatment option.