Background: In proximal tibia fracture, three column concept and fixation is becoming popular as it was proved that fixation of posterior column is a must for proper weight transmission and stability. This study aimed functional outcome of proximal tibia fracture in SCHATZKER TYPE 4, 5, 6 managed with posteromedial approach and their complication rate. Materials and Methods: This prospective case controlled clinical study was carried out in 30 patients, with ASA physical status I and II and scheduled for elective general surgery. All patients had anteriorposterior (AP) and lateral radiographs. The patients were assessed preoperative and postoperatively in form of range of movements, pain, stability, reduction of fracture and early mobilization. All patients were operated with posteromedial plating for proximal tibia via posteromedial approach and were assessed postoperatively for range of movements, stability and graded according to the knee society score. Results: In our series, the majority of the patients are found to be between the age group of 30-40 years (13). 90% of patients were male. Road traffic accident was the most common cause. Screw impingement at far cortex is most common complication. According to knee society score system, 67% patients had excellent results without any deformity and stiffness, 30% had good results. Conclusion: Posteromedial plate by posteromedial approach provide anatomical articular reduction and rigid stable fixation with less soft tissue devastation. Proximal tibia fracture augmented with posteromedial approach is the good, effective and skill-full procedure with minimum risk of superficial and deep infection, knee stiffness, deformity.