This chapter gives a detailed review of the composition, structure and biomechanics of articular cartilage in the joint. W have looked at the most common types of cartilage lesions and at the existing methods of articular cartilage repair techniques in the hip joint. Articular cartilage is specialized hyaline cartilage which makes a firm, smooth and slippery surface that resists plastic deformation. It has a unique structure and mechanical properties that provide joints with a surface that combines low friction, shock absorption and wear resistance, while bearing large repetitive loads throughout an individual's lifetime. Cartilage lesions in the hip are most common on the acetabular side and typically present as focal area of delamination or chondral flap. Joint preserving techniques are becoming increasingly common. The spectrum of options includes palliative procedures such as joint lavage and chondral debridement, reparative procedures such as microfracture and direct chondral repair, and restorative procedures such as mosaicoplasty. Preservation of the host tissue is most attractive solution to cartilage damage, particularly in young active individuals. Tissue engineering offers one solution but many problems have to be overcome before these techniques become a reality.