Closed wedge distal femoral osteotomy is a treatment method for lateral compartment osteoarthritis of the knee with valgus malalignment. The goal of this surgical technique is unloading the lateral knee compartment by shifting the mechanical axis to the medial side. Necessity of the knee arthroplasty is eliminated or postponed in physiologically young patients with high activity level. Although the closed wedge varus femoral osteotomy had been described earlier, it has been performed more successfully following the invention of blade plates achieving stable osteosynthesis. The technique maintains some relief for the complaints of patients with patellofemoral joint instability as well. Osteotomy can also be performed as secondary procedure for patients with meniscus, cartilage or ligamentous injuries. Successful outcomes can be achieved with good preoperative planning, stable osteotomy fixation with proper axis correction and rehabilitation. In this review, distal medial closed wedge varus femoral osteotomy is evaluated with results in the literature and clinical experiences.