Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of proximal tibiofibular osteotomy with exter-nal fixator for medial knee osteoarthritis. [Methods] From April 2018 to December 2021, 10 patients with medial knee osteoarthritis weretreated with the above method. The osteotomy site was determined according to the preoperative full-length X-ray film of both lower limbs.An incision was made about 3cm below the head of the fibula to remove a fibular segment 1 cm in length after drilling and osteotomy throughthe intermuscular space between the peroneus longus, brevis and the gastrocnemius. After that, the tibial osteotomy below the tibial tuberclewas conducted in the same way, and a suitable fixation ring was selected according to the diameter of the patient's lower leg, and an Ilizarov’s external frame was installed. The external frame with rings above and below the osteotomy sites fixed with Kirshner wires and threaded pinswas gradually adjusted beginning 7 days after surgery to correct the deformity. [Results] All patients had operation performed successfullywithout vascular and nerve injury during the operation, with the external fixator to be continued adjust to correct the deformity within 21 daysafter the operation. The patients wore the external fixator for (101.9±9.5) days in a mean, and got the alignment of lower limb force satisfacto-rily corrected. At the latest follow-up lasted for (2.0±0.6) years, the VAS for pain, KSS score, mechanical axis deviation (MAD) of lower ex-tremity, and medial proximal tibial angle (MPTA) significantly improved in the patients (P＜0.05). [Conclusion] Proximal tibiofibular osteot-omy with Ilizarov’s external fixator for medial knee osteoarthritis does correct the deformity effectively, and achieves satisfactory clinical con-sequences.