A modified inside-to-outside technique of meniscal repair is presented. The technique employs a 14 gauge needle that acts as the receiving conduit for a standard 10 in meniscal repair needle. The repair needle is placed into the joint through a repair cannula in a routine manner. Twenty-four meniscal repairs with an average follow-up of 26 months are presented with a clinical success rate of 92% and no complications. The technique provides a particularly effective and safe approach to the placement of meniscal repair sutures at the posterior extremes of medial and lateral meniscal tears.