Introduction: Medial compartment osteoarthritis of the knee is a common degenerative condition that leads to pain, deformity, and functional limitation. High tibial osteotomy (HTO) is a joint-preserving surgical procedure aimed at correcting varus malalignment and redistributing load from the diseased medial compartment to the relatively preserved lateral compartment, thereby relieving symptoms and improving knee function. Aims: To evaluate the clinical and functional outcomes of high tibial osteotomy in patients with medial compartment osteoarthritis of the knee. Materials and Methods: This prospective study included patients with symptomatic medial compartment knee osteoarthritis treated with high tibial medial opening wedge osteotomy. A total of 25 knees were evaluated. Patients were assessed clinically and functionally using standardized scoring systems preoperatively and during follow-up. Radiological assessment was performed to evaluate alignment correction and disease progression. Outcomes were analyzed over a follow-up period of up to one year. Result: The study demonstrated significant improvement in pain relief and functional outcomes following high tibial osteotomy. Most patients showed maximal improvement within one year of surgery. The procedure effectively corrected varus deformity and slowed the progression of osteoarthritis. Male patients were more commonly affected, and right-sided involvement was slightly higher. No major complications were observed, and bone grafting was not required in all cases.