Dome osteotomy (DO) can be utilized for the correction of coronal plane deformities of the distal tibia. With regard to alternative open or closing wedge osteotomy techniques, it allows massive correction without the disadvantages of needing a bone graft or shortening the tibia, respectively. The osteotomy center of rotation is planned at the center of the deformity. The DO is best delineated using a plate as a compass with a 3 cm radius. Once the DO of the tibia and osteotomy of the fibula are performed, adjustable correction is possible until attempted correction is achieved, while preserving bone to bone contact. Reliable stability can be achieved with the use of screws or plate. The main advantages of DO are a bone to bone contact that provides optimal stability and reliable primary bone healing at the osteotomy site. In this article, we discuss our indications and technique, addressing pitfalls and limitations.