We evaluated the radiologic, clinical results and the complications of minimally invasive percutaneous medial plate fixation in distal tibial metaphyseal fracture. From January 2010 to December 2016, 31 patients with distal tibial fracture treated by medial plate fixation using Minimal Invasive Plate Osteosynthesis (MIPO) technique were analyzed. The duration of followup was more than 1 year. We evaluated clinical results by IOWA ANKLE rating system, union time by simple X-ray and complication. The bone union was achieved in all cases at average 16.7 weeks. Average IOWA ANKLE rating score was 90.3 point. At the last follow-up, there was no non-union, angular deformity more than 5 degrees or infection. We concluded that minimal invasive percutaneous medial plate fixation for distal tibial metaphyseal fractures is a safe and useful method if there is no medial wound problem, and it is important to pay close attention to prevent angular deformity during surgery.