Supracondylar fracture of the humerus is a common childhood injury. Unfortunately in many parts of the world the child is brought to the hospital after delay of few days. Between 10–20% cases of supracondylar fracture of the humerus report late in developing countries. Delay is either due to lack of medical facilities or social and financial constraints. These fractures are classified according to the delay in starting treatment; group І 2–7 days, group ІІ delay is longer. The late cases are often closed injuries without vascular compromise; however the elbow is tense and swollen. This precludes splintage with elbow in acute flexion following closed reduction because of potential risk of vascular embarrassment. Percutaneous pinning is a good alternative but has a greater risk of iatrogenic ulnar nerve injury as the medial epicondyle is not easily palpable in swollen elbow. Several authors have cautioned regarding the risk of post operative stiffness and myositis ossificans following repeated manipulation or open reduction of a swollen elbow. The methods of treatment appropriate for recent cases are not suitable for delayed cases of supracondylar fracture. Dunlop in 1939, described management for fresh fractures with the elbow kept straight to avoid vascular embarrassment. The authors advocate the use of traction to achieve gradual reduction in patients who present late with a grossly swollen elbow. It is a safe option as it avoids all the above mentioned risks. Should an unacceptable deformity occur, it could be corrected later by osteotomy.