Objective The purpose of the this study was to evaluate the clinical outcomes after medial malleolar triplane osteotomy with non-weightbearing autograft for the treatment of osteochondral lesions of the talus. Methods A review was conducted on 23 patients(14 males and 9 females)with osteochondral lesions of the talus were treated with non-weightbearing autograft combine with medial malleolar triplane osteotomy at department of toot and ankle surgery, Honghui hospital of Xi""an Jiaotong University from September 2015 to September 2017. The mean age was 31.4 years (range: 19-46 years).The average body mass index was 25.1kg/m2 (range: 19-33kg / m2).All the patients were unilateral with 13 cases on the left and 10 cases on the right. According to"talus division", 19 cases in the fourth area, 1 case in the fifth area and 3 cases in the seventh area were divided. Ferkel classification based on CT was used for the classification of injury: 5 cases in type I, 12 cases in type IIa and 6 cases in type IIb. The preoperative and postoperative Visual Analogue Scale(VAS) after walking 1km, American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score(AOFAS) were collected and compared by student t-test. The time taken for fully weight-bearing and the occurrence of postoperative complications were recorded.Result The patients were followed up for 37.1months(range:22-49 months).At the last follow-up,the VAS decreased from 5.6±0.7preoperative to 0.7±1.0( t=33.631, P= 0.00), AOFAS increased from 56.0±9.5 to 93.8±6.6(t=33.631，P=0.000).No serious postoperative complications such as infection,medial malleolar osteotomy malunion or graft necrosis outcomes were reported.1patient developed irritation of internal fixation, and the symptoms disappeared after removing at postoperative 6 months. The general incidence of complications was 4.3% (1 / 23). Conclusion Medial malleolar triplane osteotomy with non-weightbearing autograft is an efficient approach for osteochondral lesions of the talus.The short-and-mid curative effect is satisfactory and stable. The operative technique is considerably safe, with few serious complications such as medial malleolar maluion,donor complications or graft necrosis.