Background: Osteochondritis dissecans (OCD) is a pathological process affecting the subchondral bone of the knee in children and adolescents with open growth plates (juvenile OCD) and young adults with closed growth plates (adult OCD). It may lead to secondary effects on joint cartilage, such as pain, edema, possible formation of free bodies and mechanical symptoms, including joint locking. Objective: To detect the osteochondral auto graft Transplantation in Management of OCD Knee as regards clinical outcomes and complications. Subjects and methods: This systematic review include 14 original articles published from January 2014 to June 2019 which was that 14 studies were included prospective studies were the commonest type appeared  in 6 studies followed by Case series in 4 studies , retrospective in 3 studies and Randomized controlled trial in one study. Results: Results of the study revealed that the commonest score used to assess outcome was: Knee Injury and Osteoarthritis Outcome Score (KOOS) which used in 5 studies and shows improvement after treatment, International Knee Documentation Committee (IKDC) scores appeared in 4 studies preoperative and postoperative values shows significant increase postoperative, Hospital for Special Surgery (HSS) appeared in one study, and results revealed that 54 cases showed complications, graft failure founded among 16 cases and 34 needs reoperations. Conclusion: On the basis of the good clinical and MRA results obtained at long-term follow-up, mosaicplasty can be considered a safe and reliable option for the treatment of unstable OCD in adult patients.