Autologous platelet-rich plasma (PRP) is a relatively new biotechnology backed by over two decades of research in diverse areas. With its growing use for the treatment of musculoskeletal injuries, Orthopaedic Sports Medicine may be the discipline in which translational use of PRP has progressed most rapidly. PRP therapy involves the injection of a small volume of plasma or the application of PRP gel foam directly to the site of injury. It is composed of numerous growth factors (GF) secreted from large numbers of 'activated' platelets, directed at facilitating and enhancing physiological wound healing and rapid tissue regeneration. With wide variations in preparation protocols, kits, activation methods, platelet concentrations and growth factors, many questions are still unanswered. Similarly, application methods, timing of treatment and volume of injection are inconsistent, emphasizing the need for appropriately powered level 1 and 2 studies with adequate and relevant outcome measures and clinically appropriate follow-up in order to assess the efficacy and effectiveness of all elements of PRP therapy. Clinical interventions in sports and musculoskeletal medicine aim to achieve predictable, rapid tissue repair and enhance wound heating and to restore the high mechanical performance and functional levels of non-injured tissue in the shortest possible time. PRP may be a remarkable step forward in this quest. This review will evaluate the evolution and most recent contributions of PRP treatment.