Objective To observe the clinical efficacy and safety of knee arthroscopic surgery in patients with knee meniscus injury. Methods 101 patients with knee meniscus injury treated in our hospital from August 2022 to April 2024 were selected as the study objects. Patients were divided into control group (n=50) and observation group (n=51) by random number table method. The control group was treated with traditional operation. The observation group was treated with knee arthroscopic surgery. The clinical efficacy, surgical indicators, knee function (Lysholm score) and complication rate of the two groups were analyzed and compared. Results The total effective rate of observation group was significantly higher than that of control group (P<0.05). The duration of operation, getting out of bed and staying in hospital in the observation group were significantly shorter than those in the control group, and the intraoperative blood loss was significantly reduced (P<0.05). Before operation, there was no significant difference in Lysholm scores between the two groups (P > 0.05). At 3 months and 6 months after surgery, Lysholm scores of the two groups were significantly increased with the extension of time, and Lysholm scores of the observation group were significantly higher than those of the control group at 3 months and 6 months after surgery (P<0.05). The total complication rate of the observation group was significantly lower than that of the control group. (P < 0.05). Conclusion Arthroscopic treatment of patients with knee meniscus injury can improve clinical efficacy, improve surgical indicators, enhance the knee function of patients, and reduce the incidence of complications.