Articular cartilage injuries present a challenge in terms of definitive treatment in an active population. There are many treatment options available, one of which being allograft osteochondral articular transplant (OAT), in patients with larger chondral injuries. When deciding to perform this procedure, one must be aware of preoperative and intraoperative findings that may change the treatment of a patient with a significant chondral injury. This article will discuss our preferred method of performing allograft OATS along with perioperative management and considerations of these patients.