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Aim: To study the etiology of the bucket-handle meniscal lesion, to evaluate the operative results and to analyze the relevance of the clinical and paraclinical signs likely to evoke this kind of lesions.Methods: We conducted a retrospective study that included 39 patient files collected at the Rabta orthopedic department in Tunis between January 2004 and December 2011 and who presented with an ADS lesion of the IM. The functional result was evaluated according to the ARPEGE score. Subjective outcome was evaluated according to the IKDC score. Results: The etiologies were dominated by sports accidents. The main injury mechanism was knee hyperflexion. Our medium-term results were similar to those reported in the literature. Overall, the good and very good results varied between 80 and 90%. According to the ARPEGE score, we found 84.5% excellent and good results. According to the IKDC score, at 6 months post-operatively, 84.7% of the patients judged their knee to be normal to almostnormal.Conclusion: Protect the meniscus. Meniscectomy is the procedure of last resort after the possibilities of meniscal repair have been studied.