Introduction: Calcaneum is the most commonly fractured tarsal bone. Approximately 75% are intra–articular and mostly associated with poor outcomes. The treatment of these fractures is still controversial. This study will guide us to take appropriate treatment decision.

Methods: The 44 eligible patients with calcaneal fracture were randomized into two groups i.e. closed reduction and percutaneous screw fixation and B/K cast. Primary outcomes were measured in terms of functional and radiological outcomes.

Results: The AOFAS score, VAS score and complication rate did not differ significantly between two groups. All fractures in both groups united at 3 months follow up. There was significant restoration of Bohler angle (p=0.000), calcaneal height (p=0.000) and stable calcaneal width (p=0.000) in operative group than cast group at 6 months follow up.

Conclusion: There was no significant difference between both groups despite the significantly better radiological outcomes in the operative group.