Fifteen children with segmental forearm fractures were classified into two groups based on their proximal injury pattern. Proximal injury in group A was either Monteggia fractures or its variant and in group B it was diaphyseal fractures. The distal lesions in both these groups were either a metaphyseal fracture or an epiphyseal separation, or a combination of these two. Eleven children of group A were managed conservatively, whereas three of four children in group B required open reduction. After 2.67 years of follow-up in 13 children, clinical outcome based on modified Boyd and Boal's criteria was good in eight and fair in two children of group A, and good in two children and fair in one child of group B. The clinical outcome of pediatric segmental forearm fractures is good (P=0.05) and it may frequently need surgical intervention when the proximal fracture is diaphyseal.