Meniscus allograft transplantation (MAT) has gained increasing interest over the past decade due to its promising clinical outcomes. However, its success is highly dependent on strict indications. Persistent pain either in the medial or lateral femorotibial compartment after total or subtotal meniscectomy is an indication for MAT. The knee joint must be stable, properly aligned, and free of advanced osteoarthritis (OA) greater than grade 3 according to Kellgren–Lawrence (K-L) classification. Meniscus allografts are processed as fresh frozen grafts using proprietary techniques. Accurate graft sizing—using X-ray or MRI—is crucial for maintaining the biomechanical function of the meniscus. Various techniques exist for graft fixation at the anterior and posterior horn insertions and at the periphery, attaching them to the meniscal remnant. The bony technique involves the use of a bone block or “bridge,” retaining the anterior and posterior roots of the meniscus, inserted into a prepared trough, or separate bone plugs at each horn to facilitate direct bone-to-bone healing. In contrast, the soft tissue fixation technique transplants a free graft without bone plugs using sutures alone to anchor the meniscus to the tibial bone. The technique is less demanding and allows adjustable tensioning of the meniscus. The advantage of each technique remains the subject of ongoing research to address issues of graft healing and extrusion. Favorable clinical outcomes, including return to sport, have been reported. The average graft survival rate is approximately 80% at 10 years. However, several factors such as female gender, concomitant procedures and preexisting cartilage defects have been identified as risk factors for graft failure.