Introduction: Osteoarthritis (OA) is a chronic degenerative disorder of multifactorial etiology characterised by the loss of articular cartilage, hypertrophy of bone at the margins, subchondral sclerosis, and range of biochemical and morphological alterations of the synovial membrane and joint capsule. Recent studies have confirmed the safety and efficacy of Proximal Fibular Osteotomy (PFO) in the treatment of knee OA. Objective: The aim of our study is to evaluate the effect of Proximal Fibular Osteotomy on the predominant medial compartment osteoarthritis knee in terms of Visual Analogue Scale Score. Methods: In a period of one year, 40 patients with predominant medial compartment osteoarthritis were operated in our department of orthopaedics. 2cm long fibula was resected 7 cm to 9 cm distally from the head of fibula. The outcome was evaluated by using VAS score. Follow up was done according to standard proforma. Results: In our study, the average age of presentation was 64.1 year. At final follow up, VAS score improved to 1.73 + 1.261 from 8.55 + 0.02 preoperatively (both values were significant P<0.001). Conclusion: PFO is a new and cost–effective surgery for predominant medial compartment osteoarthritis of knee with better functional outcome of patients and significant decrease in pain as compared to the conventional treatment modalities.