Objective To study and analyze the effectiveness of arthroscopic assisted minimally invasive surgery in the treatment of complex tibial plateau fractures.Methods: A total of 60 patients with complex tibial plateau fractures treated in our hospital from January 2020 to January 2023 were selected and randomly divided into a control group and an observation group.The control group was treated with traditional surgical treatment, and the observation group was treated with arthroscopic assisted minimally invasive surgery.The clinical efficacy, clinical indicators, knee joint function recovery (HSS) and pain (VAS), and complications were compared between the two groups after treatment.Results: The excellent and good rate in the observation group was significantly higher than that in the control group (P<0.05).The clinical indicators of the observation group were significantly better (P<0.05).The HSS score and VAS score of the observation group were significantly better than those of the control group (P<0.05).The incidence of complications in the observation group was lower than that in the control group (P<0.05).Conclusion: Arthroscopic assisted minimally invasive surgery in the treatment of complex tibial plateau fractures can effectively relieve the pain of patients, shorten the treatment time, reduce the incidence of complications, and promote the recovery of knee joint function.