Aim: To highlight the outcome of posterolateral and lateral approach to ankle with posterior/lateral plating of distal fibula fractures. Methodology: Twenty ankle fractures were divided into two groups. Patients were randomly allocated into two groups. In one group fibula was plated with lateral approach and another group with posterior plating. In indicated cases involving additional posterior malleolus fixation, posterior plating of fibula was done. Posterolateral/lateral approach to ankle and posterior/lateral plating of lateral malleolus was the main method used for fracture fixation. Average timing of surgery was 6 days from presentation. Minimum follow-up period was 24 months. Factors analyzed were pain, maximum walking distance, walking surfaces, wound healing, union time, and American Orthopedic Foot and Ankle Society (AOFAS) score. Results: Posterior plating showed no wound complications. Lateral plating demonstrated superficial infection in three patients and wound gaping in two patients. Posterior plating (six patients) and lateral plating (three patients) showed union within 3 months. Posterior plating (four patients) and lateral plating (six patients) demonstrated union within 3–6 months. P-value (0.062) was statistically significant but there was no significant difference clinically. Posterior plating (seven patients) and lateral plating (five patients) showed excellent functional outcome (AOFAS score > 85). Posterior plating (three patients) and lateral plating (three patients) showed good outcome (AOFAS score 70–85). In lateral group, two patients (AOFAS 55–70) showed fair outcome. p-value is statistically significant. Complications included one case of malunion in each group, three patients showed superficial infections, and two patients demonstrated wound gaping. Conclusion: Posterior approach to lateral malleolus and posterior/posterolateral plating technique allows better implant placement, lesser hardware irritation, good wound healing, practically nil wound dehiscence, and an excellent functional outcome compared to lateral approach.