Abstract: [Objective] To explore the curative effect of the high tibial osteotomy (HTO) versus unicompartmental knee arthroplasty (UKA) for medial compartment osteoarthritis of the knee. [Methods] The Cochrane Library, PubMed, EMBASE, CNKI, Wanfang, VIP and CBM database were searched for the curative effect of HTO versus UKA for medial compartment osteoarthritis of the knee from January 2000 to December 2020. Literature screening, quality assessment, and data extraction were conducted based on inclusion and exclusion criteria. RevMan5.3 was used to perform the meta-analysis of parameters related to the consequences. [Results] A total of 17 studies were included, with 1554 cases of knee joints, including the HTO group (n = 688) and the UKA group (n = 866). The results of the meta-analysis showed that in the UKA group, postoperative complications [OR=4.52,95%CI(2.30,8.90), P<0.0001] was better than those of the HTO group, but there was no significant difference between the two groups in operating time, blood loss, postoperative knee joint function, range of motion, postoperative revision rate, excellent and good rates, mechanical axis of the lower limb, cartilage degeneration and so on. [Conclusion] For medial compartment osteoarthritis of the knee patients who met the surgical indications, UKA can reach the same level as HTO in postoperative knee joint function, range of motion and revision rate, and has more advantages in reducing postoperative complications.