The use of musculoskeletal allograft tissue in reconstructive orthopaedic procedures has markedly increased over the last decade, Surgeon knowledge of tissue bank practices in donor gifting and screening, serology testing and processing is important when making the decision to use these allograft tissues. The orthopaedic surgeon also has the responsibility to inform the patient about the risks and benefits of using allograft tissue. This handout provides an overview of some of these issues.