The tibial tubercle osteotomy (TTO) is a versatile technique that has historically been utilized to treat several disorders of the patellofemoral joint, including patellar instability, focal chondral defects, patellofemoral dysfunction, and arthritic conditions. Traditionally, TTO has been performed in an open fashion, with variable rates of bone and wound-healing complications reported in the literature. The purpose of this article is to describe an arthroscopy-assisted minimally invasive TTO that aims to reduce the bone and soft tissue healing complications of open surgery.