Purpose <p>The aim of this study was to evaluate the clinical and radiological outcomes of genu valgum correction in adolescents, with medial closing wedge distal femur osteotomy using the medial approach and paediatric locking plate fixation.</p> Methods <p>25 patients (36 knees) with a mean age of 12.74 ± 1.95 years (10–17 years) with genu valgum arising from distal femur were retrospectively studied. Clinical and radiological outcomes were assessed by comparing intermalleolar distance, clinical and mechanical femoro-tibial angle (cFTA, mFTA), mechanical lateral distal femur angle (mLDFA), and mechanical axis deviation (MAD) pre- and post-operatively.</p> Results <p>The mean duration of follow up was 29.4 ± 15 months (24–62 months) and the mean time to osteotomy union was 13.6 ± 2.4 weeks (10–22 weeks). The mean mFTA improved from 14.35⁰±3.09° valgus (7°- 24° valgus) pre-operatively to 0.75° valgus (8° varus – 10° valgus) at follow up and mean mLDFA improved from 76.1⁰±3.2° (67⁰–82⁰) to 88.78⁰±2.48° (85⁰–99⁰) (<i>p</i> &lt; 0.001). There was a statistically significant improvement in cFTA and MAD (<i>p</i> &lt; 0.001) post-operatively. We reported a few complications postoperatively: overcorrection / undercorrection in 3 patients; common peroneal nerve palsy in one patient; and surgical site infection in three patients.</p> Conclusion <p>The medial approach to the distal femur is a relatively new approach for performing a medial closing wedge osteotomy for genu valgum correction in paediatric patients. It offers distinct advantages of direct visualisation of base of the wedge, easy and precise osteotomy execution, proper implant placement over the contour of distal femur, and a more cosmetic surgical scar.</p>