The meniscus of the human knee was once thought of as a vestigial structure and oftentimes excised in the treatment of meniscal pathology. As further knowledge was gained as to the vital role these structures play in normal knee health and biomechanics, a movement developed to make every attempt at preserving them in the face of trauma or degeneration. For meniscal deficient knees, allograft transplantation is an accepted treatment for pain and dysfunction with long-term data showing favorable outcomes. Novel meniscus prostheses and scaffolds show promise, but further investigation proving efficacy is necessary prior to their widespread implementation.