Degenerative and traumatic meniscus injuries should be considered two completely different pathologies requiring treatment based on entirely different principles. Degenerative tears are part of the development of osteoarthritis and should generally be treated conservatively, whereas surgery should be considered for traumatic tears to help prevent the development of osteoarthritis. In this article, we summarise which patients should be referred promptly to an orthopaedic surgeon, and which should be referred to a physiotherapist.