BACKGROUND: Osteoarthritis (OA) is the most prevalent type of arthritis in the world. With the progressive aging of the population, it is becoming a major problem of public health. Symptomatic Knee osteoarthritis (OA) is chronic, progressive degenerative joint disease with accompanying pain, stiffness, and deformity of the knee joint. Osteoarthritis is the most frequent joint disease with a prevalence of 22% to 39% in India. OBJECTIVE: To evaluate the pain relief and radiological improvement in medial joint space following proximal fibular osteotomy in medial compartment knee osteoarthritis. METHODS: From November 2018 to May 2020, 25 patients (four cases were bilateral so total of 29 knees) who underwent proximal fibular osteotomy for medial compartment osteoarthritis in teaching hospitals attached to Bangalore Medical College & Research Institute, were followed up. Preoperative and postoperative weightbearing and entire lower extremity X-rays were obtained to analyze the alignment of the lower extremity and ratio of the knee joint space (medial/lateral compartment). Functional assessment was done using Visual Analogue Scale (VAS) & American Knee Society Score. (KSS). RESULTS: A total of 25 patients and 29 knees were followed-up. Of these, 6 were male and 19 were female patient. The average age was 58.72 years. The average preoperative VAS score, KSS clinical & KSS functional score were 6.75 points, 40.31 points & 44.82 respectively. According to KL grading, there were 20 knees of grade 2 and 9 knees of Grade 3. The average postoperative VAS score, KSS clinical & KSS functional score were 2.34 points, 76.79 points & 76.72 points respectively. The medial joint space has improved significantly from a preoperative value of 1.22 mm to postoperatively 3.71 mm. The ratio of medial to lateral joint space improved from a preoperative value of 0.20 to 0.67.