Fifty-eight patients with clinical evidence of meniscal tears, documented by magnetic resonance imaging (MRI), were evaluated with regard to success of nonoperative treatment at 2 years' follow-up. Thirty-six (62%) patients had undergone surgical treatment because of persistent symptoms, whereas 22 (38%) had not undergone surgery. The majority of patients electing surgery (26 of 36) did so within the first 6 months after diagnosis. Of the 22 patients not electing surgery, 15 (68%) did not experience any significant symptoms limiting activity at follow-up; seven (32%) of these patients did, however, experience intermittent symptoms with some activity limitation. Age >40 years and avoidance of sports requiring pivoting had a positive correlation with successful nonoperative treatment. No correlation was noted with respect to sex, duration of symptoms, or location or pattern of meniscus tear on MRI. In this study, the majority of younger patients who engaged in sports requiring repetitive pivoting and jumping elected surgical treatment of their meniscal tears. Of the patients who elected surgical treatment, 84% were able to resume their preinjury level. Of the patients electing nonoperative treatment, 68% were asymptomatic and able to resume recreational activities, which typically did not involve running, jumping, or pivoting.