Abstract:【Objective】 To explore the application effect of arthroscopy-assisted minimally invasive reduction and internal fixation for patients with tibial plateau fractures. 【Methods】 A total of 80 patients with tibial plateau fractures admitted to our hospital from May 2021 to May 2025 were selected and divided into control group and observation group according to different surgical methods, with 40 cases in each group. The control group received open reduction and internal fixation, while the observation group was treated with arthroscopy-assisted minimally invasive reduction and internal fixation. Perioperative indicators (operation time, intraoperative blood loss, time to get out of bed after operation, time of full weight-bearing after operation), postoperative knee swelling, knee flexion and extension range of motion, knee joint function [American Knee Society (AKS) score] and complications were compared between the two groups. 【Results】 The operation time, time to get out of bed and full weight-bearing time of the observation group were shorter than those of the control group, and intraoperative blood loss was less (P<0.05). Postoperative knee swelling in the observation group was milder, and the maximum flexion and extension angles were larger than those in the control group (P<0.05). The knee score and function score of AKS in the observation group were higher than those in the control group (P<0.05). The total incidence of complications in the observation group was lower than that in the control group (P<0.05). 【Conclusions】 Arthroscopy-assisted minimally invasive reduction and internal fixation can reduce intraoperative blood loss and postoperative knee swelling, accelerate early functional recovery and improve knee joint function with fewer complications, which possesses high clinical application value for tibial plateau fractures.