<p>Meniscus surgery has undergone fundamental changes over the past decades. The aim of this article is to provide an overview of the historical development of meniscus surgery, from the earliest resection techniques to modern meniscus preservation techniques. Initially, the meniscus was regarded as nonfunctional and dispensable, which led to total meniscectomy becoming established as the gold standard for meniscus-related knee pain. The growing interest in degenerative alterations of the knee joint, combined with the systematic analysis of clinical outcomes from knee surgery, has led to increased research into the field of the biomechanics of the knee joint. In the course of time, it was discovered that menisci represented an essential component of the biomechanics of the knee joint and played a&#xa0;key role in preventing degenerative joint changes. Based on these findings, a&#xa0;paradigm shift occurred from total meniscectomy towards partial resections. With the introduction of arthroscopy, these procedures were performed using minimally invasive techniques for the first time, which represented a significant advance in knee surgery. Subsequently, arthroscopically performed suture techniques as well as other meniscus-preserving strategies, were established. Nowadays, reconstructive procedures, particularly meniscal allograft transplantation and the implantation of scaffolds, are becoming increasingly more important in orthopedic surgery. In addition, the mutual influences of the meniscus and leg axis, ligament stability and the properties of cartilage were identified and multimodal therapy was incorporated. Overall, there is a&#xa0;clear trend towards individualized patient-centered treatment approaches based on the morphology of the meniscal tear. The primary objective of these procedures is to prevent degenerative changes in the knee joint and to preserve long-term joint function.</p>