Fractures of the distal femur are complex injuries that can be difficult to manage and account about 7% of all femoral fractures. Distal femoral fractures mainly arise from two different injury mechanisms which are low and high energy trauma, and both these groups are differ with respect to inherent problems and complications encountered. Patients usually present with pain, swelling, deformity and inability to weight bear. Unlike many tibial plateau or pilon fractures, the majority of distal femoral fractures can be treated definitively with early operative fixation. A good classification system of femoral fractures should identify the site of involvement, good interobserver reliability, and assist in deciding the optimal treatment. At present, the most widely accepted classification of distal femoral fractures is of Muller, updated by the AO group and adopted by the Orthopaedic Trauma Association. Treatment options can be nonoperative and operative in the management of distal femoral fractures. The principles of operative management of distal femoral fractures are anatomic reduction of the articular component and indirect reduction or biological fixation of the reconstructed articular component to the metaphysis. A detailed description on the surgical approaches, devices used, individual fractures, postoperative rehabilitation, complications and implant removal have been also provided in this chapter.