[Objective] To compare the clinical effect of arthroscopic assisted minimally invasive technique and traditional open reduction and internal fixation in the treatment of tibial plateau fracture with avulsion of anterior cruciate ligament at tibial insertion. [Methods] From January 2018 to January 2019, 66 patients with tibial plateau fracture and avulsion of ACL were selected and divided into observation group (n = 33) and control group (n = 33). The control group was treated with traditional open reduction and internal fixation, and the observation group was treated with arthroscopic assisted minimally invasive technology. The perioperative indexes, postoperative pain visual analogue scale (VAS), complications and functional scores of the hospital for special surgery (HSS) at different times were compared between the two groups. [Results] The incision length, intraoperative hemorrhage and hospitalization time of the observation group were all less than those of the control group (P < 0.05). The VAS score of pain in the observation group was lower than that in the control group (P < 0.05). The time of fracture healing in the observation group was shorter than that in the control group, and the score of HSS in the patients with knee at 1, 6 and 12 months after operation was higher than that in the control group (P < 0.05). According to Rasmussen imaging score 12 months after operation, the overall effect of the observation group was better than that of the control group (P < 0.05). [Conclusion] For the patients with tibial plateau fracture and avulsion of ACL at tibial insertion, arthroscopic assisted minimally invasive treatment is less traumatic than traditional open reduction and internal fixation, with faster postoperative recovery and better knee function recovery, which is worth popularizing.