Background: knee O.A was treated by total knee arthroplasty but it is new procedure still under trial for treatment of medial compartment knee O.A. Objective: To assess the early results of proximal fibular osteotomy as a new surgery for pain relief and improvement of functions of the knee in patients with medial compartment OA. Patients and methods: From July 2016 to September 2018, 10 patients who underwent proximal fibular osteotomy for medial compartment osteoarthritis. Preoperative and postoperative knee society score (KSS) and visual analogue scale (VAS) were obtained to assess knee functions and pain Results: median knee society score (KSS) show improvement postoperatively from 83 to 105 and visual analogue scale (VAS) decreased postoperatively from 8.5 to 4. Conclusions: This study shows that proximal fibular osteotomy (PFO), a new surgery, can effectively relieves pain and improves knee function in patients with medial compartment osteoarthritis.