When unicompartmental knee arthroplasty was first introduced in the 1970s, the outcomes of medial unicompartmental knee arthroplasty (MUKA) were poor, but the few cases of lateral unicompartmental knee arthroplasty (LUKA) showed promise. Since that time, refinements in patient selection criteria, implant design, and surgical technique have been made and MUKA has increased in popularity. However, LUKA remains rarely utilized. An awareness of the indications and contraindications of LUKA and a comprehensive preoperative assessment can accurately select for patients that wound benefit from LUKA. Furthermore, with a surgical technique emphasizing conservative bone resection, restoration of neutral limb alignment, and meticulous cement fixation of fixed-bearing implants, excellent results can be obtained for LUKA. In fact, a review of the recent literature reveals that LUKA is associated with excellent long-term clinical outcomes and implant survivorship when performed in properly selected patients.