The management of medial meniscus ramp lesions can be challenging. The current gold standard technique to repair these lesions is the transnotch view combined with a single instrumental posteromedial portal. However, it does not provide direct visualization of the ramp and does not allow for an anatomic repair. In this Technical Note, a new technique is described with 2 posteromedial portals: a posteromedial viewing portal and working portal. This 2-portal approach aims to improve visualization of the lesion and its repair, as well as allow for a technically easier repair. R amp lesions are defined as tears of the posterior horn of the medial meniscus (PHMM), in particular, involving its capsular attachments with and injuries to the meniscotibial ligament. On magnetic resonance imaging (MRI), an irregular posterior meniscal outline and perimeniscal fluid signal separating the meniscus and the capsule may indicate a ramp lesion (Fig 1). 1 The sensitivity of MRI to detect ramp lesions is highly debated, however, so arthroscopic exploration remains the gold standard for proper identification of these lesions.