Articular cartilage is extremely sensitive to traumatic lesions and natural repair is very limited. When regeneration occur the tissue found in the lesion site is mostly fibrocartilage with poor mechanical properties, rendering a poor long-term clinical outcome. Cartilage lesion is a common problem with an impressive clinical and economic impact. With a difficult diagnosis in an initial disease stage, the cartilage lesion can progress to osteoarthritis and, therefore, a prompt diagnosis and treatment is required. Clinical management of cartilage lesions is a very demanding issue and the treatment is dependent of the extension, depth, location, chronicity of the lesions, patient’s conditions and patients’ expectations as well as associated lesions. In the present chapter, we present the clinical findings and diagnosis methodology to identify a cartilage lesion in an early stage. Finally, we discuss the indications, contra-indications, advantages, disadvantages and treatment decision-making as well as the outcomes of the available therapeutic approaches.