Backgound: Genu varum (Bowlegs) is among the most prevalent lower-limb misalignments correlated with pain and impairment, and it continues to be a source of concern for parents. Corrective osteotomy is generally performed on children with pathologic genu varum (GV) deformities to rectify the deformity. The treatment's purpose is to get the knee back to its normal mechanical axis. Non-surgical therapy is recommended in children under the age of three since it is difficult to distinguish between physiological bowing and early tibia vara. Various osteotomy techniques have been used, including closing wedge lateral tibial osteotomy, dome osteotomy, and opening wedge medial osteotomy. Objective: The current review aimed to figure out a better, less expensive, and more pleasant way to keep the open wedge of valgus tibial osteotomy for GV malformation without adding expense, an unsightly scar or requiring a re-operation for implant removal. Methods: PubMed, Google scholar and Science direct were searched using the following keywords: Genu varum, osteotomy, open and closed wedge osteotomy and autologous fibular strut. The authors also screened references from the relevant literature, including all the identified studies and reviews, only the most recent or complete study was included. Conclusion: Despite technological advances and new surgical operation. The treatment of GV deformity in kids is still a serious concern for parents. Various osteotomy techniques have been used, including closing wedge lateral tibial osteotomy, dome osteotomy, and opening wedge medial osteotomy. Autologous fibular strut graft is an excellent, if not superior, graft for open wedge medial tibial osteotomy because of its strength, durability in preserving correction, cost-effectiveness, ease of graft harvest, and restricted incision and pain sites.