Articular cartilage repair and restoration is an emerging clinical treatment option for patients with injury or disease of articular cartilage. An increasing body of clinical and scientific experience, as well as published literature, supports the rationale, technical aspects and clinical outcome of various methodologies in current clinical use. As a result, cartilage repair treatment is moving out of the realm of the subspecialist and becoming more widespread in the orthopaedic community. In addition, many “next generation” technologies and devices are under investigation and may soon be available for clinical application in the US. Nonetheless, there remains significant controversy and debate regarding the most appropriate use of each of the cartilage repair modalities available to orthopaedic surgeons. At the same time, patients and the general public, often fueled by popular media, are actively seeking out so called biologic treatment options for joint injury and disease. This handout reviews the four most commonly employed cartilage repair techniques: Microfracture (MFX), Autologous Chondrocyte Implantation (ACI), Osteochondral Autograft Transfer (OAT) and Osteochondral Allografting (OCA). Each of these techniques has a basic science supported rationale, established patient selection criteria, optimum surgical technique and supportive clinical outcome data. When carefully considered, these techniques provide the surgeon with a fundamentally sound basis for choosing the most appropriate intervention for a particular patient.