Background: The current study is conducted to find the radiographic axial alignments of the lower extremity in north-west Indian adult population.Methods: A observational study was conducted from May 2018 to May 2020. A total of 137 patients aged between 18-30years coming to hand clinic were randomly selected and full-length weight bearing anterior posterior and lateral view x-rays of left leg was performed and angles were measured using bone ninja application for following axial angles. Femoral neck shaft angle (frontal/sagittal plane), medial proximal femoral angle, anatomical/mechanical lateral distal femoral angle, medial proximal tibial angle, lateral distal tibial angle, posterior proximal/distal femoral angle, anterior distal femoral angle, joint line congruence angle (knee joint), mechanical/anatomical tibio femoral angle.Results: In our study medial inclination of the tibial plateau in Indian adult population is 5.4+/- 2.4 degree was greater than the commonly reported 3 degree. The tibio femoral valgus angle was 5.4degree with a range of 4-8 degree.Conclusion: Adult Indian population have more varus alignment of knee and significant higher medial inclination of tibial plateau than the counterpart western population. A 5 degree of external rotation of femoral component instead of commonly used 3degree is necessary while performing total knee arthroplasty in Indian population.