There are many factors to consider when treating an active individual with a known or suspected meniscal tear. The athlete with a meniscal tear sometimes can return to competition, temporarily delaying surgery until after the season. If an athlete remains symptomatic and is unable to return, however, then arthroscopic surgery generally is effective to allow the athlete to resume participation. The decision of meniscal repair versus excision must be carefully thought out and discussed with the athlete before surgery. Either treatment can allow the athlete to return to their sport. It is controversial whether or not an athlete should be allowed early return to play after meniscal repair. Further prospective randomized studies would provide useful information in deciding which type of treatment and which type of rehabilitation is best suited for the active individual.