Purpose of review <p>Meniscus tears are some of the most commonly managed orthopedic injuries that affect a wide variety of patient populations. Traditionally, meniscus tears were treated either conservatively or with partial meniscectomy. However, recent technological innovations have generated a rapid evolution in the modern evaluation and treatment of meniscus tears. The primary objective of this review is to provide a detailed overview of long-term results of meniscus repair after greater than five to ten years follow up, highlighting modern surgical techniques, clinical and radiologic outcomes, rates of failure and revision surgery, as well as emerging insights and future directions.</p> Recent findings <p>Advancements in arthroscopic implants and techniques helped establish meniscus repair as the preferred approach for treating many meniscal tears due to its ability to preserve native knee kinematics and decrease the risk of osteoarthritic progression. In properly indicated patients, long-term clinical data supports performing meniscus repair over traditional treatments, such as partial meniscectomy, to preserve overall knee function and longevity. The impact of tear morphology on healing rates, potential for biologic augmentation, and optimal postoperative rehabilitation are substantial areas of active research.</p> Summary <p>Undertaking a comprehensive, individualized approach evaluating careful patient selection, sound surgical technique, and ideal rehabilitation strategies is critical to guiding treatment decisions and achieving long-term successful outcomes.</p>