Knee preservation surgery is a scientific and reliable surgery, but must be selected for the right indications and patients, and should be performed by a qualified and experienced surgeon, the results of knee preservation surgery can be sure. Knee preservation surgery mainly includes osteotomy orthopedic surgery and knee preservation unicondylar surgery. Knee preservation osteotomy is an extra-articular surgery that can correct extra-articular deformities and restore the force line of the entire lower limb to the normal force line. Knee preservation unicondylar surgery is performed by placing spacers inside the joint so that there is no more bone-on-bone wear in the joint, but only wear spacers, while making the patient’s painful discomfort disappear. For this reason, knee conserving surgery is becoming increasingly popular with a wide range of patients, especially in modern times where it can be beneficial to more patients if they seek medical attention earlier. Knee preservation surgery has been performed worldwide for more than 40 years, and the technology of knee preservation surgery has progressed rapidly, especially now with 3D printing and artificial intelligence technology. The results of knee preservation surgery have been positive and encouraging, and have allowed more patients who had concerns and worries about knee replacement surgery to avoid or delay joint replacement. As a result, more and more patients are now undergoing knee conserving surgery, which, in addition to its positive results, is associated with less trauma and faster recovery.