Osteochondral transplantation is commonly used to treat chondral or osteochondral defects in the medial or lateral femoral condyle, trochlea, or patella of the knee. The procedure can be performed either arthroscopically or using a mini-open technique. Magnetic resonance imaging (MRI) is essential for assessing the cartilage defect and underlying bone to determine the appropriate treatment approach. The surgical procedure of osteochondral transplantation consists of five major steps: The chapter covers the diagnosis, surgical technique in both arthroscopic and open approaches, potential complications, rehabilitation, and clinical outcomes.