Objective To investigate the effect of high tibia osteotomy(HTO) on knee osteoarthritis and medial knee function. Methods A total of 126 patients with osteoarthritis of the medial compartment of knee joint who were surgically treated in Zhengzhou University Hospital were selected as the research subjects. Among them, 61 patients were treated with HTO technology(HTO group) and 65 patients were treated with unicompartmental knee arthroplasty(control group). The surgical trauma and postoperative rehabilitation indicators, knee function, knee imaging features, and surgical complications in the two groups were statistically analyzed. Results The operation time, intraoperative blood loss, and incision length of the HTO group were lower than those of the control group, and the difference was statistically significant(P<0.05). Compared with that before operation in this group, there were significantly higher(P<0.05). Six months after operation, the posterior inclination angle of tibial plateau and lateral patellar angle in HTO group and control group were significantly higher than those before operation(P<0.05). The femoral-tibial angle, patellar fit angle and patellar inclination angle of the patients in the group were significantly lower than those before operation(P<0.05). Conclusion The effect of HTO in the treatment of osteoarthritis of the medial compartment of knee joint is not much different from that of single knee replacement surgery. On the basis of ensuring the surgical effect, it has the advantages of short operation time, less bleeding and less trauma.