Articular cartilage damage is challenging to treat. The patient has to deal with pain, functional impairment and compromized quality of life. Ultimately, he has to face the risk of early total joint replacement. A variety of treatment options is available to improve the situation for the patient. Mosaicplasty, bone marrow-stimulating techniques and cell-based methods have been in clinical use for years. This article explains preoperative diagnosis and classification systems of cartilage lesions and presents different cartilage repair procedures and their indications.