Abstract:[Objective] To compare the clinical outcomes of arthroscopic cystectomy (AC) , arthroscopic internal drainage (AID) and tra- ditional open cystectomy (TOC) for popliteal cyst. [Methods] A retrospective analysis was performed on 108 patients who underwent surgi- cal treatment for popliteal cyst in our department from March 2015 to March 2019. According to preoperative doctor-patient communication, 38 patients underwent AC, the other 35 patients underwent AID, while the remaining 35 received TOC. The perioperative, follow-up and im- aging data of the three groups were compared. [Results] All the 108 patients had the corresponding procedure performed successfully with- out neurovascular injury and other complications. The AC and AID groups were significantly superior to the TOC group in terms of incision length, operation time, blood loss, postoperative ambulation, incision healing and hospital stay (P＜0.05) . The AID group had significantly shorter operation time than the AC and TOC groups (P＜0.05) . As time went in follow-up period lasted for more than 12 months, the VAS score significantly decreased (P＜0.05) , while the Lysholm score significantly increased in all the 3 groups (P＜0.05) . At last follow-up, the AC and AID groups got significantly lower VAS scores than the TOC group (P＜0.05) , while the AC group was marked significantly higher Lysholm score than the AID and TOC groups (P＜0.05) . Radiographically, the AC and AID groups had significantly lower recurrence of popli- teal cyst than the TOC group (P＜0.05) . However, there were no significant differences in Kellgren-Lawrence grade of knee degeneration among the three groups at any corresponding time points (P＞0.05) . [Conclusion] The arthroscopic cystectomy and arthroscopic internal drainage have the advantage of low cyst recurrence over the traditional open cystectomy. Among them, arthroscopic cystectomy does achieve more satisfactory knee function recovery.