Open fractures are a well described entity in the literature of Orthopaedics. However review of literature and patients attending fracture clinics and hospitals around the world indicates that the fracture epidemiology (in general) is changing very quickly [2, 3, 4, 5, 6, 7, 8, 9]. The same is true for open fractures as well. Worldwide literature is deficient in determining the changing characteristics, pattern and outcome of open fractures. With the intention of improving our hospital approach towards open fractures, we felt the need to audit our current management and outcome of such injuries. This study was conducted to assess the characteristics and outcome of surgically treated open fractures in our set-up. Aims and Objective: To study the clinical profile and outcome of open fractures treated surgically with reference to general health, limitations of activities, physical health problems and social activities and upper and lower limb involved. Also assess the union (by x-ray) and health of patient at the end of 6 month by SF-36 questionnaire. Methods: This observational prospective cohort study was carried out at the Department of Orthopedics, at a state run 1500 bedded tertiary care hospital attached to post-graduate teaching institute located in central Gujarat, from July, 2019 to November, 2020 with due permission from Institutional Ethics Committee. During this period, 60 patients with open fractures were treated surgically under one unit. This study being a surveillance, all patients included were closely observed for a period of 6 months from the date of presentation, while they were being treated. No study specific alteration was done in the management which was decided on individual merits by the treating surgeon. All subjects were evaluated with respect to the demographic data, history of fracture being treated, presenting symptoms and signs, current management and outcome as outlined in the Performa (see Annexure). The outcome was considered favorable if the fracture united at final follow up and unfavorable if otherwise and also assessed according to SF - 36 questionnaire. Results: Out of 57 fractures in our study, 41 open fractures showed union at final follow up and the remaining 16 ended in non-union. 76% of Open Grade I fractures united at final follow up where as 38.8% of Open Grade II fractures united at final follow up and 90% of Open Grade IIIA fractures united at final follow up. Among OG IIIA fractures 50% of fractures were small bones of Hand and Feet. All those fractures showed full union at final follow up. 33.33% of Open Grade IIIB fractures united at final follow up. In our study all upper limb fractures showed union compared to lower limb fractures of which 60% showed union at final follow up. In our study, Patella fractures showed 60% of non-union at final follow up. Average age of patients was 40 years. Male to female ratio was 4:1. Most patients (66.6%) were from the active phase of their life. Most patients were operated within 5 days of admission. A statistically significant association was seen between grade of open fractures and duration of Hospital stay. As grade of open fracture increased duration of Hospital stay also increased. Tibia was the most common bone fractured (43.85%) followed by Radius-Ulna (15.78%), Small bone of Hand and Feet (14.03%), Femur (12.28%), Patella (8.77%) and Humerus (5.88%). In our study 50% of Open Grade III fractures had complications like infection, failure of fixation and limb length discrepancy. In our study 50% of patients with Open Grade III fractures showed less than 65 score of SF-36 questionnaire at final follow up and 51.16% of patients with Open Grade I & II fractures showed more than 80 score of SF-36 questionnaire at final follow up. However no statistically significant association between score of SF-36 and grade of open fractures was elicited. Conclusion: We justified from our results that we should continue surgical fixation of open fractures as per our Hospital protocol so as to decrease the duration of Hospital stay and improve the outcome in relation to activities of daily living. However, more intensive treatment is advocated for open fractures of lower limb especially the severe variety. Bone grafting as a adjuvant to fracture healing may timely improve the outcome in such fractures.