Abstract: Rotational alignment after total knee arthroplasty is crucial for the postoperative outcome and survival expectation of prosthesis. In recent decades, improving evaluation and surgery technique, like navigation system, have notably promoted the precision of rotational alignment of total knee arthroplasty. The evaluation methods of rotational alignment, its effect on post-op function and the advances of latest computer-assisted navigation technique in total knee arthroplasty are briefy reviewed in this article.