Background: Women patients who have undergone high tibial osteotomy need management to control walking and balance and to enable functional daily life. In that way, land-based physical therapy and aquatic physical therapy were performed. Objectives: To investigated the effect of land-based and aquatic physical therapy on the balance and walking of women who had undergone high tibial osteotomy. Design: Randomized control trial. Methods: In all, this randomized controlled trial enrolled 21 patients with high tibial osteotomy who received land-based physical therapy (LP, n=7), aquatic physical therapy (AP, n=7), and land-based and aquatic physical therapy (LAP, n=7). Single-leg standing balance, 10-m walk test, and Knee injury and Osteoarthritis Outcome (KOOS-12) scores were. The intervention period was 3 days per week for 6 weeks. Results: One-leg standing balance and 10-m walk test increased statistically, and KOOS-12 score also increased statistically. All three groups have improved. As a result, the variable changes were compared in three groups, and although there was no significant difference between the land-based and aquatic physical therapy groups, the land-based and aquatic physical therapy combined programs improved further than the previous two groups. Conclusion: The balance and walking of female patients with high tibial osteotomy were found to have been very effective in land physical therapy and aquatic physical therapy. In addition, the land-based and aquatic physical therapy combination program can improve balance and walking more effectively.