Tibial plateau fracture is treated with percutaneous minimally invasive techniques to protect the local soft tissue and promote bone healing due to the thin skin of the proximal tibia. Detailed CT 3D reconstruction is required to accurately determine the type of fracture prior to treatment. The main goal of treatment is to restore the alignment of the lower limb, followed by precise repositioning of the articular surfaces and restoration of joint stability. Surgical navigation and arthroscopic techniques are essential to verify the effectiveness of the reduction. Fracture stabilisation can be achieved with bone cement, cannulated screws or minimally invasive percutaneous plates. The key to percutaneous surgery is to protect metaphyseal blood supply, not the size of the incision, to ensure quality of healing and long-term stability. Compared to open reduction, percutaneous surgery not only performs better in Schatzker type I, II, and III fractures, but also in complex fractures, where it has the advantage of being less invasive and reducing complications.