Background: Many methods have been proposed to treat displaced supracondylar fractures of the humerus in children, most are either closed reduction and pinning in different configurations or Open reduction and pinning with.different approaches. There remains controversy in the literature with regards to some topics, these topics could be grouped into: method of reduction (open vs. closed), pin configurations, iatrogenic nerve injury and impact of time to surgery in complications. Methodology: A total of 70 patients with Type III supracondylar humerus fracture who fulfilled the inclusion criteria were randomly divided into two groups, 35 in each. Group I children were treated with closed reduction and crossed pinning and Group II with open reduction and crossed pinning. Both the groups were followed up for a period of 12 months at regular intervals. Assessment of cosmetic factor  & functional factor  was done by using Flynn’s Criteria.. Results: All the fractures were found to be united clinically and radiologically by 6 wks. As per Flynn’s Criteria 91% cases in closed group showed excellent results whereas 80% cases in open group showed excellent results after 1 year of follow up. 3 cases in closed group had iatrogenic ulnar nerve injury. No cubitus varus deformity encountered in any group. Conclusion: Both open and closed reduction with crossed pin configuration provide stable fixation. Restriction of range of motion was more in the open group at 6 months follow up however at 12th month follow up the outcomes were similar. Closed reduction and crossed pinning allows early range of motion but it is technically difficult and satisfactory reduction is difficult to obtain in cases with severe soft tissue swelling.