Consider PFO as an alternative to high tibial osteotomy in some cases (HTO). Osteoarthritis in the medial compartment of the knee is treated surgically (KOA). There are various benefits of PFO over HTO. First and foremost, the surgical procedure is straightforward and straightforward. A smaller incision, little tissue dissection, and no internal fixation are some of the advantages of this procedure. In addition, the recuperation time after surgery is much quicker than it would be with HTO. In addition, HTO problems might have a negative impact on a patient's prognosis. The study's goal was to examine the functional and radiological outcomes of proximal fibular osteotomy treatment for medial compartment osteoarthritic knees. Methods: Our research comprised 20 patients with medial compartment knee osteoarthritis who had proximal fibular osteotomy between January 2018 and June 2019. Early findings of proximal fibular osteotomy for the treatment of medial compartment knee OA are shown in this research. Clinically, after three, six, nine, and twelve months after surgery, knee function was evaluated with KSS and radiographically, by measuring medial and lateral joint space. There was a substantial rise in KSS scores from 46.80 preoperatively to 82.05 at the 12th month postoperatively in this research (p 0.001). This research shows a considerable increase in medial joint space. In this research, the average lateral joint space change was 7.5 mm. Over the course of all planned follow-up visits, significant decrease was seen. All patients who underwent PFO reported feeling less discomfort in the midsection. Unicompartmental Osteoarthritis may benefit from PFO treatment. To determine whether the positive benefits of PFO are long-lasting, future studies will need to follow up for a longer length of time