The meniscal ossicle is an infrequent radiographic finding in humans. It has long been recognized in relation to trauma to the meniscus. Previous theories as to the etiology of these ossicles have been that they are vestigial or result from metaplastic change in an area of injury. We present four patients with meniscal ossicles associated with a longitudinal tear of the medial meniscus. The origin of the ossicle was an avulsion of the insertion of the posterior horn of the medial meniscus. Arthroscopic resection in these patients resolved their symptoms.