Between 1986 and 1997, 25 active National Football League (NFL) players underwent microfracture to treat full-thickness chondral lesions. Average follow-up was 4.5 years (range: 2-13 years). Preoperative and postoperative data were rated according to symptoms (4 = severe, 1 = none), function (5 = unable to perform, 1 = no limitations), and activity level (10 = full activity, 1 = unable to perform). Nineteen (76%) players returned to football the season following microfracture. Six players retired for various reasons. At follow-up, pain, swelling, running, cutting, and squatting improved. Activities of daily living, strenuous work, and strenuous sport levels also improved. Those who returned to play averaged 4.6 seasons of participation (range: 1-13 seasons) and 56 games (range: 2-183 games) after microfracture. Nine (36%) players continue active participation in the NFL. Results of microfracture to resurface full-thickness chondral lesions in high-demand NFL players are encouraging. Microfracture is safe, effective, and appears to improve symptoms, function, and activity levels in NFL players.