Meniscal tears are one of the most common knee pathologies, and arthroscopic meniscectomy is a frequently performed procedure. The importance of preserving the meniscus, due to its role in chondroprotection and secondary knee stability, is well-accepted. Meniscal repair techniques have evolved over time from initial open repairs to arthroscopic inside-out and outside-in repairs, and more recently to repairs using all-inside devices. In this article, the authors reviewed the function, anatomy and biomechanics of the meniscus, and discussed the literature to support the argument for repairing meniscal tears.