Chondral injuries affect athletes of all competitive levels with increasing frequency and can lead to chronic joint degeneration left untreated. These debilitating injuries are exacerbated by repetitive high-impact, cutting, and pivoting movements and can produce pain, recurrent effusions, and mechanical symptoms in the affected knee. Symptoms frequently persist despite conservative treatment due to chondrocyte’s limited potential for intrinsic healing and the high mechanical demands of athletic activity. Surgical treatment options and rehabilitation protocols vary based on lesion size, depth, and location. Postoperative rehabilitation is a critical component of the treatment process and must include consideration of the biology of the cartilage repair or reconstruction technique, chondral defect characteristics, sport specific mechanical demands, and individualized biopsychosocial factors to achieve optimal outcomes. The treatment of cartilage injury is a complex and best managed by a multidisciplinary team with carefully indicated surgery and rigorous, criteria-based progression through a comprehensive individualized rehabilitation program. Most patients are able to return to sport following surgery and maintain the high mechanical demands of athletic activity while minimizing the risk of further joint degeneration.