The menisci play a critical protective role for the knee joint through shock absorption and load distribution. Currently, the consensus in surgical treatment of meniscal tears is to preserve as much functional meniscal tissue as possible. The health professional is challenged to choose the best treatment, both in the short- and in the long-term. A degenerative lesion in the middle-aged or older patient could suggest early-stage knee osteoarthritis and should be treated accordingly. Surgical resection of nonobstructive degenerate lesions may remove only the evidence of the disorder while the osteoarthritis degradation proceeds. Well-designed randomized, controlled clinical trials are needed.