Introduction Symptomatic chondral defects in the knee can be devastating injuries to the competitive skier. Outcomes after microfracture in these high-impact athletes have not been previously reported. The purpose of this study was to evaluate results of microfracture in the professional skier. Methods Twenty active elite skiers having undergone knee microfracture surgery performed by two surgeons at our institution between 1986 and 2008 were included in this study. Demographic data were obtained for each patient, along with outcome scores and objective performance data. Results Twenty patients (23 knees) with an average age of 23.1 years (range: 15-29) were studied (16 female, 4 male). Follow-up information was available on 20 knees with a minimum follow-up of 2 years (87%). Average time from microfracture surgery to final follow-up was 77 months (range: 24-255). Mean lesion size was 155 mm2 (range: 5-450 mm2 ). One knee underwent microfracture of a bipolar lesion. Twenty-two of 23 knees (96%) returned to competitive skiing. Average return to competition was 13.4 months (range: 0.5-25.3). Mean patient satisfaction scores were 9.8 (range: 6-10). Mean Tegner and Lysholm scores were 8 (range: 3-10) and 86 (range: 41-100), respectively. Conclusion Patients with symptomatic chondral lesions of the knee can return to a high level of competition following microfracture surgery. Ultimately, 22 of 23 (96%) knees were able to return to ski racing. Microfracture is a reliable method of treating chondral lesions in these high-impact athletes.