Background: Tibial plateau fractures are a risk to the functional integrity of the knee. They are the result of axial compressive forces alone or combined with Varus or valgus stress on the knee joint. Post-traumatic osteoarthritis occurs after traumatic injury to the joint. The presence of residual incongruity at the time of fracture healing could lead to joint stiffness and long-term morbidity, studies have established the restoration of articular congruity as the key principle on the management of these injuries. Despite anatomical joint reconstruction, development of osteoarthritis may still take place secondary to the initial articular cartilage injury. This prospective study evaluates the functional and radiological outcome of surgically managed tibial plateau fractures and incidence of osteoarthritis. Methods: In this prospective study 240 patients with tibial plateau fractures managed by different modalities were included. Patients were evaluated by Rasmussen criteria clinically and radiologically by Kellgren & Lawrence grading for development of osteoarthritis at 6 weeks, 3 months, 6 months, 1 year and then subsequent follow-ups. Results: Rasmussen clinical scoring system showed excellent results in around 34% (82) of the patients, 53% (127) had good,9% (22) fair and 4% (9) poor results. Out of 240 patients 78 (32.5%) developed OA knee (including Kellgren and Lawrence grade 1) which is a significant number of patients. With increase in schatzker type & amount of articular depression the number of patients developing Osteoarthritis increased, schatzker Type I -16 % vs schatzker Type VI - 54% and no articular depression 9.5% vs > 5mm articular depression 46 %. Conclusion: With increase in schatzker type & amount of articular depression the chance of patient developing Osteoarthritis significantly increases and thus excellent anatomical reduction with restored articular congruity rigid fixation is required to facilitate early knee motion and reduces chances of post-traumatic osteoarthritis.