Focal articular cartilage defects are common in sports medicine, which usually lead to joint pain and dysfunction. Due to the characteristics of cartilage without blood vessels and lack of endogenous repair cells, the cartilage has limited self-healing ability and will eventually develop into osteoarthritis if left untreated. Surgery has always been the main means of clinical treatment of articular cartilage defects. According to the surgical repair technology, it can be divided into four categories: palliative surgery, repair surgery, reconstruction surgery and cartilage replacement surgery. In this paper, the recent progress of indications, advantages, limitations and long-term efficacy of the above different surgical methods in the treatment of focal cartilage defects are reviewed.