The traditional dual-option debate of cruciate-retaining versus posterior- stabilized knee arthroplasty designs has evolved into a more complex discussion in recent years. The growing interest and rapid adoption of medial conforming and medial pivot designs has made the original debate surrounding cruciate-retaining versus posterior-stabilized designs more interesting. Each liner option has its own advantages and disadvantages. Although conforming tibial liner options are increasing rapidly, traditional cruciate retaining and posterior stabilized are the most common designs, as recorded in most registries. However, it is important to understand the updated pros and cons of each liner design as surgeons focus on personalization of their total knee arthroplasty procedures to the individual patient. Different liner options may be more advantageous in certain situations or vary with surgical technique. Several different types of tibial liner options are currently available, and it is important to review and summarize the latest literature available for each.