Summary Meniscal tears are the most common injuries to the knee. The menisci have important functions within the knee, and loss of a meniscus from surgical meniscectomy significantly increases the risk of subsequent development of degenerative changes within the knee. In younger patients, some meniscal tears may be repairable, and there is now a wide variety of different techniques available for meniscal repair, with highly encouraging published clinical results. In patients with a painful knee where there has already been a previous meniscectomy, meniscal replacement by meniscal allograft transplantation may be a viable option. However, in the future, solutions may well lie within the field of tissue engineering.