Total Knee Arthroplasty (TKA) is a procedure to replace the diseased or damaged knee joint with artificial prosthesis for the relief of disabling pain and restoring the function of knee. Total Knee Arthroplasty (TKA) is one of the most common and successful procedures in modern orthopedics and is spreading through the world. Many surgeons are developing their skill but it needs experience and patience for successful outcomes. There are different factors which affect the outcome after total knee arthroplasty, among them;the coronal alignment of lower limb plays a major role. Many studies have supported that neutral mechanical alignment after total knee arthroplasty leads to better function. The aim of this review is to evaluate clinical outcome with reference to the coronal alignment of the limb and safety based on Western Ontario and McMaster Universities (WOMAC), Knee Society Score (KSS) score.