The osteochondral autograft transfer is a commonly used technique for the treatment of osteochondral lesions of the ankle. It allows for the repair of the cartilage defect and the underlying subchondral damage in one procedure. An autologous graft, which is composed of hyaline cartilage on top of a bony cylinder, is transplanted into the defect area on the talus. The most frequently used donor site for the graft is the nonweight-bearing area of the ipsilateral knee joint: the most proximal portion of either the lateral or the medial femoral condyle. This technique has shown promising mid-term results in the treatment of circumscribed osteochondral lesions, and patients have been able to return to sports after the procedure. Unlike bone marrow-stimulating techniques, autologous grafts provide a hyaline articular cartilage matrix for the defect area. The transplanted chondrocytes can potentially maintain the matrix and provide a permanent chondral surface. Potential donor site morbidity has been discussed in the literature, but only in rare cases, does this seem to limit patients.