Abstract: Objective To evaluate the clinical outcomes of surgical treatment for femoral shaft nonunion via para-rectus femoris approach. Methods From January 2015 to September 2016, 11 patients with femoral shaft nonunion underwent surgical treatment via para-rectus femoris approach in our department. The intermuscular plane, length of the incision, operating time, blood loss, VAS score, fracture healing time and complication were recorded. All surgeries were performed by the same surgeon. Results All patients achieved union. The time to healing was 3-8 months. The types of revision surgery were as follows: exchange nailing+augmentation plate in 2 cases, bone autografting in 1 case, augmentation plate in 8 cases. The para-rectus femoris approach through the rectus femoris-vastus medialis intermuscular plane was adopted for 7 patients and through the rectus femoris-vastus lateralis intermuscular plane for 4 patients. The length of incision was 5-10 cm; operating time was 100-240 min; blood loss was 100-600 ml.No complication occurred. Conclusion The para-rectus femoris approach provides a relatively small incision which allows maximal exposure of the fracture and reliable internal fixation. It may be a potential option for surgical treatment of femoral shaft nonunion.