A degenerative meniscus lesion is a slowly developing lesion, typically involving a horizontal cleavage of the meniscus in a middle-aged or older person. There is often no clear history of an acute knee injury. The most common location of a degenerative meniscus lesion is the body and/or posterior horn of the medial meniscus. The pathogenesis is not fully understood. First-line treatment of degenerative meniscus tears should be non-operative therapy focused on analgesia, and physical therapy to provide pain relief as well as improve function of the knee joint. Arthroscopic partial meniscectomy or repair may be proposed in the presence of persistent pain/mechanical symptoms for a degenerative meniscus with normal X-rays and abnormal MRI (Grade III meniscus lesion). Arthroscopic surgery has no benefit for a degenerative meniscus lesion with osteoarthritis diagnosed on weight bearing radiographs.