[Objective] To study the effect of minimally invasive percutaneous plate fixation (MIPPO) under arthroscope on patients with SchatzkerⅡ,Ⅲ tibial plateau fracture. [Methods] 120 patients admitted to our hospital from January 2016 to December 2019 were included in the study and divided into experimental group and control group according to the treatment, with 60 cases in each group. The control group was treated with open reduction and internal fixation (ORIF), while the experimental group was treated with MIPPO under arthroscope. Operative time, intraoperative blood loss, length of hospital stay, fracture healing time, knee range of motion 6 months after surgery, pain stress index and serum inflammatory factors before and after surgery, and operative complications were compared between the two groups. [Results] All patients completed the operation successfully and were followed up for 6 ~ 18 months, with an average of (12.12±1.57) months. The experimental group was superior to the control group in operation time, intraoperative blood loss, hospital stay, fracture healing time and knee range of motion 6 months after operation, with statistically significant differences (P<0.05).The levels of SP, PGE2, NPY, CRP, IL-1 and IL-8 in the experimental group 7 days after surgery were all lower than those in the control group, and the differences were statistically significant (P<0.05).The incidence of postoperative complications in the experimental group was lower than that in the control group, with statistically significant difference (P < 0.05). [Conclusion] MIPPO under arthroscope surgery is minimally invasive, which can effectively improve the range of motion of the knee joint in patients with tibial plateau fracture, reduce the degree of pain and inflammation, effectively reduce the occurrence of postoperative complications, realize early functional exercise, and facilitate functional recovery.