Femoral fractures in children are not common injuries, and the treating physicians should master non-operative and operative treatment options. Non-accidental injury is frequently seen in children below two years of age. In this review, we describe a range of techniques for treatment of the injuries, and the current treatment trends and matters of discussion are early spica casting, age and weight guidance for use of flexible and rigid intramedullary nails. We advocate early consultation with a tertiary care centre for guidance and planning of the best treatment modality.