PURPOSE: The purpose of this study was conducted to evaluate the clinical results of proximal tibial plateau fractures treated with open reduction and internal fixation through the lateral submeniscal approach and allowed early motion of the knee and to evaluate the effectiveness of the approach. MATERIALS AND METHODS: From January 1998 to December 2002, fifty four patients who underwent open reduction through the lateral submeniscal approach for proximal tibia plateau fracture and had a follow-up more than one year were included in this study. Clinical results were evaluated by postoperative radiographs taken at the last follow-up and Porter's assessment method. RESULTS: Anatomical reduction was achieved under direct vision through the submeniscal approach in most of the cases in this study. The postoperative radiographs showed anatomical reduction in 32 cases (59%) and adequate reduction with displacement within 2 mm in 20 cases (37%). The clinical evaluation by Porter's assessment method revealed that 49 cases (91%) were acceptable results of excellent or good at the final follow-up CONCLUSION: This study indicates that open reduction and internal fixation through the lateral submeniscal approach can be a good option for proximal tibia plateau fractures because it allows accurate reduction of the articular fractures, which is confirmed directly during operation, identification and repair of associated soft tissue injuries are facilitated, sufficient bone graft and stable fixation of the articular fragments under direct vision allow early motion of the knee.