110 patients with a humeral shaft fracture were randomized to either operative treatment through minimally invasive plate osteosynthesis or nonoperative treatment through functional bracing. The purpose of this study was to compare functional, clinical, and radiographic outcomes between groups, as well as the incidence of severe and minor complications. The primary outcome was the Disabilities of the Arm, Shoulder, and Hand (DASH), questionnaire. The only significant difference in DASH scores between groups was observed at 6 months favoring the MIPO group. The MIPO group also has a lower incidence of nonunion and lower anteroposterior angular displacement compared to the functional brace group. Other clinical/functional outcomes, such as the Constant-Murley score and a visual analog score for pain, did not significantly differ between groups at any time point.