Objective To investigate the clinical efficacy of proximal tibial wedge osteotomy combined with allogeneic femoral head grafting treatment for medial compartment knee osteoarthritis. Methods Retrospective analysis of 20 medial compartment knee osteoarthritis cases in our hospital from June 2014 to April 2016, which were treated with proximal tibial wedge osteotomy combined with allogeneic femoral head grafting. To evaluate the effect of the above procedure by the change of femorotibial angle (FTA) and pain visual analogue score (VAS) before and after the operation. Results This group consisted of 3 males and 17 females. The average age was (56±3.4) years; The body mass index was 23. 4±3. 8; Left knee was in 9 cases, right knee was in 11 cases. All the patients were knee varus with medial compartment osteoarthritis. The osteoarthritis score of the patients were lower the Ahlback grade II. The mean follow-up time was (14.6±5.8) months. At the last follow-up, the FTA was 173.6°± 2.4°, and the VAS was 0.6±1.2, showing significant difference when compared with the preoperative values (P＜0.05). Conclusions The application of proximal tibial wedge osteotomy combined with allogeneic femoral head grafting for the treatment of knee varus with single compartment bone joint can obtain good clinical effect.