This study evaluated the predictability of clinical examination alone in comparison with magnetic resonance imaging in the diagnosis of meniscal tears in competitive athletes. Ninety-three competitive athletes were prospectively investigated between 1992 and 1995. A total of 57 athletes were operated on based on clinical examination alone, and the 36 remaining athletes had magnetic resonance imaging before surgery. The correct diagnosis of a meniscal lesion was made on clinical examination alone in 83 athletes (89%) and on magnetic resonance imaging the correct diagnosis was also made in 89% of 36 athletes. The overall values for the clinical investigation of the medial and lateral menisci combined were 94.5%, 91.5%, 99%, 96.5%, 87% for accuracy, positive predictive value, negative predictive value, sensitivity, and specificity, respectively. The overall values for magnetic resonance imaging of the medial and lateral menisci combined were 95.5%, 96.5%, 91.5%, 98%, 85.5% for accuracy, positive predictive value, negative predictive value, sensitivity, and specificity, respectively.