Articular cartilage injuries of the knee are an increasingly common source of pain and dysfunction, particularly in the athletic population. In the athlete, untreated articular cartilage defects can represent a career threatening injury and create a significant obstacle in returning to full athletic participation. The markedly limited healing potential of articular cartilage often leads to continued deterioration and progressive functional limitations. Numerous studies have shown that full thickness articular cartilage lesions are frequently encountered at the time of arthroscopy, particularly associated with athletic injury. A variety of surgical treatment options exist, including debridement, microfracture, osteochondral autograft, osteochondral allograft, and autologous chondrocyte implantation. Each technique has advantages and limitations for restoring articular cartilage function, and emerging technology continues to improve the results of treatment. Our article provides an evidence-based review on the etiology and prevalence of articular cartilage injuries in athletes, along with the principles and techniques available for restoring articular cartilage function following injury.