Open fracture wound adds significant morbidity to the patients. Soft tissue management and infection control in the era of increasing antibiotic resistance are challenges for doctors. Negative pressure wound therapy (NPWT), also known as vacuum-assisted closure (VAC) has been reported to increase the healing rate, promote wound bed granulation, prepare the wound bed for closure and remove exudates. It is widely used in wound care and promoted for use on complex (open wounds). Negative pressure wound therapy is regarded as a novel and adjunctive therapy that can be used to heal difficult open tibia fracture wounds and many studies have proven its efficacy. Materials & Methods: Thirty patients of Gustilo-Anderson type IIIa and type IIIb open tibial fracture were taken up for the study. After thorough debridement of wounds, NPWT was applied for 7 days and different parameters were compared. Results: After NPWT wound size decreased significantly from 6.53×4.43 cm2 to 5.52×3.45 cm2, the mean CRP level decreased from 4.93 to 2.74. Only 6 (20%) patients in the study population required soft tissue procedures for wound closure. Fractures united with a mean union time of 22.46 ± 7.79 weeks. Superficial infection developed in 2 patients (6.67%) and deep infection developed in 5 patients (16.67 %) in this study. Conclusions: The use of NPWT decreases the need for soft tissue procedures like skin grafting and muscle flap overall. The need for flap coverage has been converted into SSG after NPWT and the wounds requiring SSG healed without any procedure after NPWT application. This method can lead to a better outcome by reducing wound surface area. Increased local blood flow to the wounds decreases tissue bacteria levels. NPWT can be used as a prophylactic measure to prevent high-risk wounds from becoming more infected.