Introduction. Meniscal tears in middle-aged patients are common. There is a lack of consensus regarding the optimum management of these injuries. Although arthroscopic partial meniscectomy (APM) is a frequently performed surgical option, literature has failed to prove its effectiveness over conservative approaches. Materials and Methods. We retrospectively reviewed 102 middle-aged (age > 40 years) patients who had been treated for meniscal tears between January 2010 and December 2012. We followed these patients up telephonically to assess knee outcome satisfaction rates, any early (6 weeks) improvements in pain and knee function and their pre-morbid and post-treatment activity levels (Tegner Activity Scale). Results. There were 65 male and 37 female patients with an average age of 58 years (range 40–79). After their first consultation 72 patients were treated conservatively and 30 patients were treated with an APM. There were no reported complications following surgery. We managed to contact 87 patients who were followed up at an average of 17.5 months (range 5–34 months). Overall, 72.4% of patients managed were satisfied with their knee outcomes. APM had a 78.9% satisfaction rate and 67.3% of patients treated conservatively were satisfied. There were no significant differences in early or long term pain or knee function improvements between APM or conservative modalities. 89.7% of patients returned to the same or better activity levels after treatment. There was a 1.5 times greater risk of worse activity level following APM. There was a 79.3% satisfaction rate in patients who remained at the same activity level (p=0.00). Analysis showed 21 of the 72 conservatively treated patients failed this approach. APM was performed on 18 of them resulting in a 75% satisfaction rate for this group. Conclusion. APM and conservative management produce equivalently good results for meniscal tears in middle-aged patients. Delayed surgery does not negatively influence the outcome of these patients. NO DISCLOSURES