Objective:To compare the efficacy of internal fixation and external fixation in the treatment of pelvic fractures.Methods:A retrospective case control study was conducted to analyze the data of 66 patients with anterior pelvic ring fracture treated from December 2015 to December 2017 at First People's Hospital of Lianyungang, including 36 males and 30 females, with an average age of 42.7 years (range, 19 to 63 years). There were 36 patients with Tile type B fractures and 30 with Tile type C fractures. Minimally invasive percutaneous internal fixation through the anterior inferior iliac spine was performed in 33 patients (internal fixation group) and external fixator was employed in another 33 patients (external fixation group). The two groups were compared in terms of the operation time, intraoperative blood loss, fracture healing time, fracture reduction assessment with Matta criteria, Majeed score and surgical complications.Results:All patients were followed up for 9-24 months (mean, 14.5 months). The operation time was (33.7±3.6)minutes in internal fixation group , and (24.5±3.5)minutes in external fixation group ( P<0.05). Intraoperative blood loss was (25.8±3.3)ml in internal fixation group and (21.8±4.3)ml in external fixation group ( P<0.05). The fractures were healed acceptably, with the healing time of (13.8±1.6)weeks in internal fixation group and (21.7±1.9)weeks in external fixation group ( P< 0.05). According to the Matta criteria, internal fixation group showed excellent results in 17 patients, good in 14, fair in 2 and poor in 0, with the excellent and good rate of 94%; external fixation group showed excellent results in 14 patients, good in 12, fair in 6 and poor in 1 , with the excellent and good rate of 79% ( P>0.05). For Majeed function score, the results in internal fixation group were excellent in 18 patients, good in 13, fair in 2 and poor in 0, with the excellent and good of 94%; the results in external fixation group were excellent in 14 patients, good in 12, fair in 7 and poor in 0, with the excellent and good of 79% ( P>0.05). After operation, frequent urinary occurred in one patient, unilateral femoral nerve partial paralysis in one, nail cap stimulation in two and incisional redness, swelling and exudation in one in internal fixation group. In external fixation group, there were 5 patients with nail rod exudation. Conclusion:Compared with the external fixator, the internal fixation for pelvic fractures is less invasive and more reliable, can accelerate fracture healing without interfering with the patient's daily life, and can be used as the final fixation.