Genu valgum is a risk factor for patellofemoral maltracking and recurrent instability and may cause mechanical overload of the lateral compartment leading to early arthritic changes in some patients. In skeletally mature adolescents, a varus-producing distal femoral osteotomy will correct the valgus malalignment when the femur contributes to the overall lower extremity deformity. The goal of a distal femoral osteotomy is to correct the lateral distal femur joint angle and restore a neutral mechanical axis through the center of the knee joint.  We aim to discuss the indications and contraindications, pros and cons, preoperative planning, osteotomy options, surgical techniques, and postoperative protocol for a distal femur corrective osteotomy.