Tibial plateau fractures are intra-articular fractures of the proximal tibia and metaphysis. Up to 60% of tibial plateau fractures involve the lateral plateau, with a lateral split fragment found in 75% of the fractures. Key physical exam components include a thorough soft tissue assessment and neurovascular exam. In the case of lateral tibial plateau fractures, indications for surgery include joint instability resulting from articular depression, condylar displacement, or rupture of collateral or cruciate ligaments. These fractures can generally be fixed through the anterolateral approach to the knee to restore joint congruity and elevate depressed articular fragments. Bone substitutes like injectable calcium phosphate cement or cancellous graft can be used to fill the metaphyseal void prior to definitive fixation. The functional and radiographic outcomes for operative fixation of these injuries are generally excellent but some patients may develop post-traumatic arthritis despite adequate surgical fixation.