The meniscal posterior root maintains knee stability. When torn, the circular structure of the meniscus is disrupted, with function similar to total meniscectomy, can induce osteoarthritis (OA). Therefore, early diagnosis and treatment of meniscal posterior root tear are crucial. Currently, the repair techniques for medial meniscus posterior root tear (MMPRT) are progressively transitioning from traditional transtibial pull-out repair toward reversed suture anchor technique. Combining these with biological augmentation agents such as platelet-rich plasma (PRP) may improve clinical outcomes. This review aimed to enhance clinicians’ understanding of the early diagnosis and treatment of posterior meniscus root tears by discussing the anatomy and biomechanics of the posterior root, injury mechanisms, clinical manifestations, imaging characteristics, and treatment options. By doing so, it sought to promote timely and appropriate treatment strategies to preserve articular cartilage function to the greatest extent and improve patients’ long-term quality of life.