Genu varum is a common deformity associated with medial compartmental osteoartheritic Knee. High tibial osteotomy (HTO) is an efficient surgical technique for correction of mechanical axis deviation and stress disturbances across the Knee joint in such deformity.Meticulus patient selection for good operative results is a must, so as detailed preoperative planning.Surgical techniques has undergone many modifications with resultant good effects and little complications instead of Total Knee Arthroplasty which in sometimes is unaffordable.