Abstract：Objective To discover the effect of different operative timing on the efficacy and prognosis of internal fixation for multiple rib fractures. Methods    From Jan. 2019 to Dec. 2020, 93 patients with multiple rib fractures admitted in our hospital selected as research objects were divided into the early group（≤72 h after injury, n＝50）and the late group（＞72 h after injury, n＝43）according to the operation timing. The indicators of two groups including duration of operation, intraoperative blood loss, total postoperative drainage volume, drainagetube indwelling time, length of hospital stay, C-reactive protein（CRP）, D-Dimer（D-D）and VAS pain score and incidence of complications were compared. Results The operation time, drainage tube indwelling time, and hospital stay in the early group were shorter than those in the late group. The C-reactive protein and D-dimer values were lower than those in the late group. The VAS score on the first day after surgery was lower than that in the late group, the differences in the two groups all were statistically significant（t＝－2.507, －2.203, －6.526, －2.148, －3.213, －3.737, all P＜0.05）; the incidence rate of postoperative complications was lower than that of the late group, and the difference between the two groups was statistically significant（χ2＝4.5543, P＜0.05）. Conclusion Early internal fixation surgery（≤72 hours）in patients with multiple rib fractures has more favorable clinical outcomes and prognosis.