Tendon and osteochondral allograft are key requirements for reconstructive orthopaedic surgery. Their successful use has been published repeatedly, however, they are associated with potential significant problems, which both patients and surgeons should be aware of. This review highlights the advantages and disadvantages associated with the clinical use of both tendon and osteochondral allograft. Particular emphasis is paid to graft immunogenicity, viability, incorporation and disease transmission, with specific examples from the literature illustrating each point.