Abstract: [Objective] To investigate the influence of anterolateral approach knee arthroscopic assisted reduction and internal fixation on knee joint function and articular surface collapse in patients with tibial plateau fractures. [Methods] From January 2018 to January 2020, the clinical data of 95 patients with tibial plateau fractures were analyzed retrospectively. Among them, 49 patients underwent ARIF by anterolateral approach as the observation group, 46 patients underwent conventional open reduction and internal fixation (ORIF) as the control group. The perioperative conditions of the two groups were compared, the Lysholm knee joint function score and joint range of motion were evaluated, and the imaging collapse was evaluated by follow-up.The perioperative conditions of the two groups were compared. The American Hospital for Special Surgery (HSS) score and Lysholm score were used to evaluate knee joint function, the joint mobility was measured, imaging collapse was evaluated by follow-up. [Results] The incision length, operation time, intraoperative blood loss, postoperative drainage volume, 3d postoperative pain visual analog scale (VAS) score, returned to ambulation time, hospital stay and full-weight bearing activity time in the observation group were lower than the control group (P<0.05). At 3 months after operation and at the last follow-up, the HSS score, Lysholm score, and knee mobility of the observation group were higher than those of the control group (P<0.05). Immediately after operation and at the last follow-up, the Rasmussen radiology score of the observation group was higher than that of the control group, the articular surface height and correction loss were lower than the control group (P<0.05). During the follow-up period, the incidence of complications in the observation group was lower than that in the control group (P<0.05). [Conclusion] Knee arthroscopy-assisted reduction and internal fixation by anterolateral approach is safe and effective for the treatment of patients with tibial plateau fractures, which can promote knee joint functional rehabilitation, reduce articular surface collapse, and improve clinical prognosis.