Meniscal root tears are defined as lesions at the insertions of the menisci. Since their first identification, they are now considered a major orthopaedic issue regarding the biomechanics of the knee joint. Menisci integrity is required for proper load transmission to the knee. These injuries cause changes in joint loading and weight load bearing due to failure of the meniscus to resist compression. It can result in joint overstress and degenerative changes in the knee. The lesions can be divided in two main categories: acute injuries and chronic injuries. Acute lesions usually are traumatic in origin and involve mainly the lateral meniscus. Chronic lesions are degenerative and the medial meniscus is most likely to be affected. The goal of this review is to make a descriptive distinction between all the possible lesions of the roots of the menisci, to identify risk factors and how to make a diagnosis. All these steps are meant to evaluate all the possible treatments, conservative and surgical, in order to get the best positive clinical outcomes out of it.