Introduction.The incidence of distal radius fractures is increasing together with the average age of population. Intra-articular incongruity is the most probable cause of unsatisfactory outcome of distal radius fractures. There is much debate regarding the optimal treatment of displaced, unstable distal radius fractures in the elderly. The purpose of this retrospective study was to compare outcome for elderly patients with intra-articular distal radial fracture who were treated with or without surgical intervention. Materials and methods. This cross sectional study examined patients over the age of fifty years old who were treated with or without surgery for intra-articular distal radial fracture. Patients who underwent non-operative treatment were treated with closed reduction and below elbow cast for six weeks. Patients who underwent surgery were treated with criss-cross K-wire and bone graft. Baseline radiographs with Scheck's score and functional scores with Mayo wrist score were obtained prior to treatment. Outcomes at fixed time points were compared between groups with standard statistical methods.Results.There are 27 patients intra-articular distal radial fracture between January to July 2011. 17 patients were treated conservatively with closed reduction and below elbow cast and 10 patients were treated operatively with criss-cross k-wire and bone graft. There is no significance differences between two groups in term of Scheck's score and Mayo wrist score.Conclusions.Both non-operative treatment with closed reduction and below elbow cast and operative treatment using criss-cross K-wire and bone graft provides good results in terms of radiological dan functional outcome in women patients older than 50 years old with intra-articular distal radius fracture.