Abstract: [Objective] To analyze the clinical efficacy and safety of "4" typeface flap resection for popliteal cyst undergoing arthroscopic surgery. [Methods] A retrospective analysis was performed on 78 cases of popliteal cyst undergoing arthroscopic resection in our hospital from January 2017to July 2021. Patients in the "4" type group received arthroscopic flap resection in the "4" font position (34 cases), and patients in the traditional supine position group received arthroscopic popliteal cyst resection in the traditional supine position (44 cases). The observation indexes included perioperative period and follow-up period. [Results] The operative time, intraoperative blood loss and postoperative drainage of patients in the "4" group were significantly shorter than those in the traditional supine group (P<0.05). During follow-up, the incidence of adverse reactions in the "4" character group was significantly lower than that in the traditional supine position group (P<0.05). HSS score, VAS score, Lysholm knee score, range of motion of knee joint and Angle of lower limb force line in the "4" group were significantly better than those in the traditional supine group (P<0.05). [Conclusion] In patients undergoing arthroscopic surgery, "4" lovalectomy was associated with a lower incidence of complications, better recovery of knee function, and better pain relief; At the same time, compared with traditional supine arthroscopy, the operation time, intraoperative blood loss and postoperative drainage of perioperative indicators is more advantageous.