Computer navigation for high tibial osteotomy allows multiplane measurements of leg axis to be made intraoperatively in real time, and allows, to some extent, compensations to be made for preoperative planning of shortcomings. Clinically, computer navigation significantly improves postoperative leg axis accuracy, and reduces correction variability with fewer outliers, and furthermore, it significantly reduces radiation time. This paper reviews the advantages, clinical results, complications, pitfalls, and the posterior tibial slope control in navigated open wedge high tibial osteotomy.