Proximal tibial metaphyseal region is made of cancellous bone which has a rich vascular supply, like other metaphyseal region of bones. Although it is advantage, non-unions can occur after tibial plateau and proximal tibial metaphyseal fractures resulting from high energy traumas and proximal tibial osteotomies. Tibia plateau and proximal tibia non-unions are rare due to excellent blood supply and soft tissue support. While deciding on treatment options, biological and mechanical conditions of fracture site, and patient`s systemic conditions should be evaluated. Main principles of non-union treatment in tibial plateau and proximal tibia fractures are providing fixation balance with implant exchange, and autologous bone graft.