Abstract:We report a 51 year old male with open double segmental fracture of both bones of left leg after being allegedly hit by a car. Patient was initially treated by toileting, debridement and nailing, followed by bone grafting at a later date. Segmental tibial fractures are uncommon and double segmental fractures/ trifocal fractures are rarely seen, literature search revealed that only three such cases and only one treated previously by intramedullary nail. Intramedullary nail remains effective treatment modality of such fractures and these fractures often require bone grafting.