Knee arthroscopy, a minimally invasive procedure, has transformed the treatment of knee pathologies by enabling direct visualization and management with minimal tissue disruption. Recent advances in precision medicine have introduced a new dimension to this field, allowing for highly individualized surgical approaches considering each patient's unique genetic, environmental, and biomechanical characteristics. This review explores the integration of precision medicine into knee arthroscopy, focusing on tailored approaches and emerging technologies. Key innovations such as robotic-assisted surgery, advanced imaging, and patient-specific instrumentation have enhanced surgical accuracy and patient outcomes, reduced recovery times, and minimized postoperative complications. The review also examines the role of biomarkers in guiding personalized treatment strategies, including ligament reconstructions, meniscal repairs, and cartilage restoration, which are now being refined to cater to the specific needs of individual patients. While the benefits of these innovations are clear, there are challenges to widespread adoption, including cost, resource allocation, and the need for further research to validate the efficacy of precision-driven approaches in knee arthroscopy. Moreover, the ethical considerations surrounding personalized medicine, such as patient privacy and genetic data usage, must also be addressed. Despite these barriers, the future of knee arthroscopy in the era of precision medicine holds great promise, with ongoing developments in artificial intelligence, genomics, and biomarker discovery poised to further refine patient-centered care. This comprehensive review provides valuable insights into how precision medicine reshapes knee arthroscopy, offering a glimpse into the future of more targeted and effective orthopedic interventions. By embracing these advancements, surgeons and healthcare providers can ensure optimal outcomes for patients undergoing knee arthroscopy.