There is an improvement in the treatment of proximal tibial fractures in the recent years due to the new defined concepts in orthopedic traumatology. Different fixation methods can be used in proximal tibia and each method has its own advantages and disadvantages. After the development of locked plates in 1990`s, minimal invasive procedures have become popular also in proximal tibial fractures. Protecting the soft tissues with these minimal invasive procedures is particularly important in the proximal tibia region. Since closed reduction is used usually, it is very important to be familiar with the indirect reduction techniques when performing minimal invasive surgery. In intraarticular fractures, first anatomical reduction and stable fixation of the articular surface is mandatory. Then a laterally locked plated is applied submuscularly in order to bridge the comminuted metaphyseal area. Many specially designed locked plates with aiming devices are available for the treatment of proximal tibial fractures with minimal invasive technique. Minimal invasive plate osteosynthesis is a successful treatment method for proximal tibial fractures with high and rapid union rates and low complications.