Objective To analyze the clinical efficacy and safety of arthroscopy in patients with tibia plateau fracture complicated with cruciate ligament injury.Methods From July 2016 to July 2018, 69 patients with tibia plateau fracture complicated with cruciate ligament injury were selected as the research subjects. They were randomly divided into arthroscopy group (n = 35) and routine group (n = 34). The routine group was treated with conventional open reduction and internal fixation, while the arthroscopy group was treated with minimally invasive reduction and internal fixation assisted by arthroscopy. The operation time, incision length, intraoperative blood loss, hospitalization time and healing time were statistically compared between the two groups, and the functional recovery and clinical efficacy of knee joint between the two groups were evaluated and compared. The complications of the two groups were counted.Results The amount of intraoperative bleeding in arthroscopy group was less than that in routine group. The hospitalization time, healing time and incision length in arthroscopy group were significantly shorter than those in routine group (P < 0.05). After treatment, the scores and total scores of knee joint function in both groups were higher than those before treatment, and the score items were lower than those before treatment (P < 0.05). The score and total score of knee joint function in arthroscopy group were higher than those in routine group, deduction items are lower than that in regular group (P < 0.05). The total effective rate of arthroscopy group was 91.43%, which was significantly higher than that of routine group (70.59%) (P < 0.05). The total incidence of complications in arthroscopy group was 2.86%, which was lower than that in routine group (23.53%) (P < 0.05).Conclusion The patients with tibia plateau fracture complicated with cruciate ligament injury are treated by arthroscopy with less trauma, shorter operation time and recovery time, better functional recovery of knee joint, fewer related complications and better safety.