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Andy Nanda,1 Eric C Hans2 1Department of Surgery, IronHorse VetCare, Dublin, CA, USA; 2Department of Surgery, MedVet Indianapolis, Indianapolis, IN, USACorrespondence: Eric C HansDepartment of Surgery, MedVet Indianapolis, 9650 Mayflower Park Dr, Carmel, IN 46032, USATel +1 317 872 8387Fax +1 317 872 1964Email ehans.dvm@gmail.comAbstract: Cranial cruciate ligament (CCL) rupture is one of the most common causes of pelvic limb lameness in dogs. In a CCL deficient stifle, joint lameness develops from cranial tibial translation in relation to the distal femoral condyles. The tibial plateau leveling osteotomy (TPLO) is a well-described surgical procedure that neutralizes tibiofemoral shear force by altering the tibial plateau via a proximal tibial osteotomy, and subsequently restores normal limb function. Current literature for the TPLO was reviewed and used to describe the optimal patient selection and to report clinical outcome with the TPLO in comparison to other surgical options for CCL rupture. The clinical outcomes reported to date, particularly those utilizing objective outcome data, support the TPLO as being able to consistently return dogs to normal limb function with a low risk for long-term morbidity. The TPLO procedure was found to be widely applicable to dogs ranging from small breed to large and giant breed, and does not appear to have some of the limitations that exist with alternative surgical options. This review concludes that the TPLO is an excellent treatment option for any dog with CCL rupture due to the excellent long-term outcome and high rate of owner satisfaction previously reported. Despite these conclusions, it is important to remember that treatment selection for CCL rupture remains dependent on multiple considerations including patient factors, surgeon experience, and costs.Keywords: TPLO, CCL, canine stifle, lateral suture, TTA