Objective To compare the effectiveness of arthroscopy assisted percutaneous internal fixation and open reduction and traditional surgery tibial plateau fractures.Methods From August 2013 to April 2014, 78 patients with tibial plateau fractures according to random number table were divided into group A and group B, 39 cases in each. A group of traction using arthroscopic surgery, group B with traditional open bag reduction surgery.Results The operation time, intraoperative and postoperative bleeding less and wound lesion area was shorter and less in group A than that in group B; while the healing time and HSS score was faster and higher than that in group B. The difference was statistically significant (P < 0.05); the follow-up time of the two groups show no significant difference (P > 0.05); postoperative complication rate in group A was lower than that in group B, and there is significant difference (P < 0.05).Conclusion Both treatment methods can achieve good clinical results, but arthroscopically assisted treatment of tibial plateau fractures reset shorter operative time, less blood loss, healing time is shorter, less complications, but higher HSS score, etc., which reduced the suffering of patients and improved the outcome.