Autologous cultured chondrocyte transplantation was introduced in Sweden in 1987 for the treatment of full thickness chondral defects of the knee. The results from the first 219 patients with a follow up of 2–10 years treated using this technique are reported. Patients were assessed with three types of endpoints: patient and physician derived clinical rating scales, arthroscopy assessments of cartilage fill, integration, and surface hardness and histology of graft biopsies. There was a high percentage of good to excellent results (84–90%) in patients with different types of single femoral condyle lesions, while other types of lesions had a lower degree of success (mean 74%). Furthermore, the long-term durability of the grafted area has been evaluated in a group of 61 patients with femoral condyle and patellar lesions who where followed for a mean of 7.4 (range 5–11) years and where the durability was calculated as the comparison between the long-term follow up and clinical status at 2 years post surgery. At 2 years, 50 of 61 patients treated were classified as satisfactory and at mean 7.4 years follow up, 51 of 61 were graded satisfactory. Twelve defects tested biomechanically demonstrated stiffness values ≥ 90% of normal in 67% of the patients and 8/12 graft biopsies showed hyaline-like characteristics. The good clinical long-term outcomes of autologous chondrocyte transplantation in these studies are encouraging. Future research programs contain a series of randomized studies on the different clinical repair methods available and more research on the cell sources, matrices and repair tissue evaluation.