Hyaline articular cartilage is an avascular, low-friction, and wear-resistant weight bearing surface that has limited capacity for self-repair. The optimal treatment for cartilage lesions has yet to be established. Various treatment methods are employed to reestablish a stable cartilage surface, including microfracture, autologous and allograft osteochondral transplantation, autologous chondrocyte implantation (ACI), matrix-associated chondrocyte implantation (MACI), and allograft juvenile cells (De Novo NT ®). In this chapter, a brief summary of cartilage function, repair capacity, treatment options, outcomes, and future directions are reviewed and summarized.