This study aimed to evaluate the outcomes of two surgical methods—closed reduction with percutaneous pinning (CRPP) and open reduction with internal fixation (ORIF)—in the treatment of supracondylar fractures of the humerus in children. A total of 40 pediatric patients with Gartland Type 3 supracondylar fractures were treated at Al-Hussein Teaching Hospital, Samawa city, between 1st September 2022 and 1st May 2023. The study sample included 26 male and 14 female patients, with an average age of (mean age to be filled). The fractures were classified into 35 cases of extension type and 5 cases of flexion type. Patients were treated with either CRPP (20 cases) or ORIF (20 cases), with the procedures performed under general anesthesia and imaging guidance. The primary aim was to compare the effectiveness of CRPP and ORIF in terms of anatomical outcomes, including Baumann’s angle, carrying angle, and loss of mobility. Follow-up assessments were performed weekly for the first month and biweekly for the next two months, with radiological evaluations using anteroposterior (AP) and lateral elbow views. The findings indicated that CRPP provided superior results when compared to ORIF in terms of preservation of anatomical alignment and functional outcomes. The CRPP group showed minimal deviations in Baumann’s angle and carrying angle, as well as better maintenance of elbow mobility. Moreover, the incidence of complications was lower in the CRPP group. The study also examined variables such as sex, fracture mechanism, and limb side, all of which were consistent with typical patterns of supracondylar fractures in children. In conclusion, the CRPP technique was found to be more effective than ORIF in treating supracondylar fractures in children, offering better functional outcomes and fewer complications. These results suggest that CRPP should be considered as the preferred method for managing these fractures in pediatric patients