Unicompartmental knee arthroplasty (UKA) has increasingly become an attractive alternative to total knee arthroplasty for early intervention. Clinical and biomechanical studies have shown that UKA offers advantages in early recovery, more natural function, and patient satisfaction. The literature has also shown that UKA exhibits a higher rate of revision than total knee arthroplasty, particularly in registry studies that include patients from outside of high-volume specialty centers. Patient-specific UKA offers the potential to close the gap between the known advantages of a partial knee solution and the documented risk of early revision. On the basis of the patient’s own imaging data, patient-specific UKA allows for an anatomically matched implant design that provides personalized fit, full coverage of the tibial cortical rim, and preserves the femoral articulating geometry. These design advantages are paired with a patient-specific instrument system that provides reliable component placement and simplified balancing.