We reviewed 19 patients with tibial shaft fracture treated with ACE tibial nail from December 1992 to August 1997. There were 13 males and six females with a mean age of 36.2 years (range: 18-78 years). The average follw-up period was 19 months (range: 5 to 40 months). Bone union was achieved in all cases. Some complications were however seen breakage of distal interlocking screw: 1 case, fibula head erosion by proximal interlocking screw: 1 case, and tibial shaft fracture during removal of the nail: 1 case. The ace tibial nail proved to be a favorable apparatus, but presented some problems during removal.