The meniscus is an essential structure for long-term knee health. However, while meniscectomy is still the most commonly performed knee arthroscopic surgery, there has been an increase in meniscus substitution procedures in recent years. Paramount for the success of this surgery is the correct patient selection and combination with additional knee-preserving procedures such as ligament reconstruction, osteotomy, and cartilage treatment. It is also mandatory to perform a careful and accurate preoperative clinical and imaging evaluation for correct preoperative planning. Current indications include patients suffering from the “post-meniscectomy” syndrome, who present irreparable meniscal tears or degenerative loss of meniscal tissue between 25% and 50% of the meniscus circumference, intact anterior and posterior meniscus, and up to moderate knee osteoarthritis (OA). This chapter aims to discuss indications, preoperative evaluation, surgical technique, outcomes, and controversies of meniscus scaffold procedures, with particular emphasis on the Actifit® and Collagen Meniscus Implant (CMI) experiences.