[Objective] To study the imaging characteristics of type IIIe tibial plateau fracture by DR film analysis, and to focus on the correlation between the change of posterior slope and the degree of eminence of proximal anterior cortex. [Methods] From April 2010 to May 2014, the DR films of 26 patients with hyperextension fracture of the lateral and medial tibial plateau were analyzed, classified and measured, and the difference and correlation between the data were statistically tested. [Results] In the patients with type IIIe tibial plateau fracture, there was a linear dependence between the reduction of posterior slope and the protrusion of proximal anterior tibial cortex. The regression equation was y=3.761+0.797x. The proximal fibular compression fracture was more likely to occur in women than in men. The occurrence rates of "three-line sign", "single-line sign", "reverse lip sign" or "cross sign" were about 70%. [Conclusion] For type IIIe tibial plateau fractures, the change of posterior slope can be assessed by measuring the degree of eminence of proximal anterior cortex. Women are more likely to have proximal fibular compression fractures, and the discovery of imaging signs such as "three-line sign", "single-line sign", "reverse lip sign" or "cross sign" can help to reduce the misdiagnosis and mistreatment of this type of fracture.