Arthroscopy of the knee under local anesthesia was performed on 50 patients for operative and diagnostic purposes between January and May of 1991. 20 cc of 0.5% bupivacaine with 1: 200,000 epinephrine was injected into knee joint without a pneumatic tourniquet. The operative record of each patient was reviewed to determine postoperative diagnosis and treatment. The effectiveness and level of patient acceptance of this anesthetic technique for operative arthroscopy of the knee under local anesthesia for routine operative arthroscopy was found to be safe, reliable, practical, and to have a high patients acceptance rate.