Based on the concept of knee preservation, periarticular knee osteotomy is a commonly used, safe, and effective knee-preserving procedure in clinical practice. It corrects osseous deformities (extra-articular deformities) through osteotomy and modifies the mechanical axis of lower extremity load transmission.Therefore, periarticular knee osteotomy not only preserves the normal anatomical structures but also effectively relieves pain, maintains knee function, restores partial working ability of patients, and delays the progression of knee osteoarthritis (KOA). Periarticular knee osteotomy mainly corrects varus and valgus deformities of the knee joint, aiming to redistribute the load across the knee compartments. At present, there are various types of periarticular knee osteotomies, each with its own advantages and corresponding indications. This article reviewed relevant studies on different osteotomy techniques in clinical practice, summarizes the characteristics, indications, advantages, and disadvantages of common procedures, so as to provide guidance for clinical treatment.