© 2015 Wolters Kluwer Health, Inc. The uncorrectable valgus knee provides an increased challenge for total knee arthroplasty due to the decreased lateral femoral bone stock, tight lateral soft tissues, and lax medial structures. The less utilized lateral parapatellar (LPP) approach potentially has advantages over the medial approach by allowing direct visual exposure to the pathologic side while achieving the lateral soft tissue release during surgical access. The advent of computer-assisted surgery (CAS) has increased the accuracy of component positioning. Nevertheless, neither the LPP nor CAS is performed routinely. The use of a LPP approach in conjunction with CAS for fixed valgus knees produces reliable and reproducible results.