Injuries involving subchondral bone and chondral tissues are found in up to 63 to 66% arthroscopic procedures and represent a challenging entity to treat with an important propensity to progress to osteoarthritis. Treatment options include osteotomy, microfracture, abrasion arthroplasty, autologous chondrocyte transplantation, mosaicplasty, autologous osteochondral graft, and arthroplasty; however, all these options have limitations and are not suitable to larger, contained full-thickness cartilage defects. Since its early description by Eric Lexner in 1908, osteochondral allograft techniques have evolved to our days with different success rates depending on the technique used. They are mainly indicated for symptomatic defects greater than 3 cm in active young patients in which native cartilage is preferred over arthroplasty. Osteochondral allografts provide viable hyaline cartilage with metabolically active chondrocytes and subchondral bone with remodeling potential to the articular surface and promising results according to evidence. Osteochondral allografts have been used widely in femoral condyles, tibial plateau, patella, and ankle; however, they have been used in other joints recently, such as the elbow and shoulder.