Meniscal injuries are among the most common orthopaedic injuries seen in knee clinics. Meniscal tears can occur as a result of acute injuries or chronic degeneration. However, the exact incidence of meniscal tears is difficult to ascertain because of the high number of asymptomatic tears and the high rate of degenerative tears in patients with advanced degenerative joint disease. The management of patients with knee pain is non-operative both for degenerative meniscal tears and degenerative joint disease in its initial stages. Magnetic resonance imaging has little added value in the management of middle-aged and elderly patients with degenerative disease. Failure to respond to non-operative measures warrants orthopaedic assessment with radiographic studies and counselling on managing degenerative joint disease both non-operatively and operatively. This article focuses on assessment and management of degenerative meniscal tears.