Twenty tibial plateau fractures were surgically treated by means of the double images of the arthroscopy and the image intensifier. The purpose of this attempt was (1) obtaining more anatomical reduction of articular margin, (2) preventing knee joint from the surgical dissection and (3) simultaneous diagnosis & management of the combined meniscus and ligament injuries. Three aims of this study are searching for (1) the indications of the arthroscopic surgery for the libial plateau fractures, (2) the techniques of the arthroscopic surgery for reduction and fixation and (3) the techniques for reducing the risk of the arthroscopic surgery. As a result, we can obtain more anatomical reduction and excellent or good functional knee score after follow-up study of a mean of 1 year and 9 months. There is no complication with regard to arthroscopic surgery. But anatomical reduction of the bicondyle fractures with severe articular and metaphyseal comminution was technically difficult. So, the other technique as if open reduction will be needed.