Tibial plateau fractures can range from a simple lateral split pattern to very complex bicondylar injuries that can be a source of great disability. these fractures can provide a challenge for both junior as well as for senior surgeons alike. careful evaluation of the mechanism of injury and fracture pattern plays a crucial part in the operative planning. Assessment of the soft tissues shoul be performed carefully and adequate imaging is mandatory to allow a more detailed evaluation of the fracture architecture and pre-operativeplanning. Timely accurate reduction and fixation is the goal. Over the last decade the surgical approach chosen has been largely determined by the fracture pattern. Internal plate osteosynthesis through antero-lateral and postero-medial incisions is the most commonly utilised technique for complex bi-condylar fractures. An early range of motion with special attention to full knee extension is essential for a successful functional outcome. Application of the principles mentioned is a pre-requisite to achieve the best result. New fixation techniques, such as locking plates, have not changed those principles but helped to apply them more reliably.