This study describes the epidemiology of knee articular cartilage injuries in the National Football League (NFL) and the typical treatment approach by NFL team physicians. All knee articular cartilage injuries in the league database from 1992 to 2006 were reviewed, and team physicians were surveyed about their treatment approach to these injuries. A total of 118 cases were identified, for an average of 8 per year, with a higher injury rate during games compared with practice. Approximately half of the injuries occurred in linemen, and the most common site of injury was the femoral condyle. Forty-six percent of these injuries were treated surgically, with slower return to play after surgery (124 versus 36 days, P < 01). Among team physicians, microfracture was the most popular treatment approach (43%), followed by debridement (31%) and nonoperative management (13%). More research is needed to compare long-term outcomes based on lesion size in these athletes.