Aim: This study aims to compare the outcomes of traditional open surgery and arthroscopic surgery in the management of shoulder and knee injuries, focusing on surgical duration, intraoperative blood loss, postoperative pain, recovery, functional outcomes, and patient satisfaction. Materials and Methods: A prospective comparative study was conducted on 100 patients with rotator cuff tears, meniscal injuries, ligament injuries (ACL tears), or labral tears requiring surgical intervention. Patients were randomly assigned into two groups: Group A (n = 50) underwent traditional open surgery, while Group B (n = 50) underwent arthroscopic surgery. All procedures were performed by experienced orthopedic surgeons. Postoperative assessments included pain scores (VAS), range of motion (ROM), functional scores (Lysholm Knee Score and Constant-Murley Shoulder Score), complication rates, hospital stay, return to daily activities, and patient satisfaction scores. Statistical analysis was performed using SPSS, with a p-value of <0.05 considered statistically significant. Results: The arthroscopic surgery group showed significantly better outcomes in multiple parameters. Surgical duration was shorter (55 ± 10.3 min vs. 85 ± 12.5 min, p = 0.001), and intraoperative blood loss was lower (100 ± 25 ml vs. 250 ± 40 ml, p = 0.002). Postoperative pain scores at 24 hours and 2 weeks were significantly lower in Group B (p = 0.0001, p = 0.0005, respectively). Hospital stay was shorter (2.1 ± 0.6 days vs. 4.2 ± 0.8 days, p = 0.002). At 6 months, functional recovery was superior in the arthroscopy group (Lysholm Knee Score: 88 ± 5.2 vs. 78 ± 6.5, p = 0.001; Constant-Murley Score: 85 ± 6.1 vs. 72 ± 5.8, p = 0.0005). Return to daily activities was earlier in Group B (6 ± 1.8 weeks vs. 10 ± 2.3 weeks, p = 0.002). Patient satisfaction was significantly higher in the arthroscopy group (8.9 ± 1.0 vs. 7.1 ± 1.2, p = 0.001), while the complication rate was lower (5% vs. 12%, p = 0.04). Conclusion: Arthroscopic surgery provides superior outcomes compared to traditional open surgery, with shorter operative times, reduced intraoperative blood loss, less postoperative pain, faster recovery, and improved functional outcomes. Additionally, it is associated with higher patient satisfaction and lower complication rates, making it a preferred surgical approach for shoulder and knee injuries.