Background: Knee osteoarthritis is a chronic progressive degenerative disease characterized by pain and disability. With increase in mean life expectancy, there is need to alleviate the symptoms for a better life. In developing nations with limited medical and financial resources procedures like total knee arthroplasty(TKA) is limited to a few. So a relatively new procedure proximal fibular osteotomy(pfo) with rapid relief of pain and shorter post-operative recovery time is being studied. Aims and objective: To study the effectiveness of PFO in treatment of osteoarthritis of medial compartment of knee. Materials and method: In this prospective observational study, 32 patients were selected by simple random sampling, subjected to PFO and followed up with functional parameters Numerical Pain Rating Scale(NRS) and Knee Society Score(KSS), radiological parameters tibio-femoral angle and ratio of medial to lateral joint space on post-operative day 2, at 3 months and 6 months and stride width analysis pre-operatively and post-operatively. Result: We observed that there was improvement in functional and radiological parameters after PFO in the immediate post-operative period with further improvement in these parameters and decrease in stride width at the end of 6 months. Also complication was significantly less with dysaesthesia along the distribution of superficial peroneal nerve noted in 4 patients and anesthesia along its distribution found in 1 patient. At 6 months of follow-up dysaesthesia persisted in 1 of the patients whereas the other patients were relieved at 6 months.Conclusion: We concluded that PFO can significantly improve the radiographic appearance and function of the affected knee and decrease knee varus as evidenced by decrease in stride width. It may be a viable treatment option for early medial compartment OA K.L. Grade 1,2.