Bone marrow aspirate, prolotherapy, platelet-rich plasma,and autologous conditioned serum represent alternative treatment options that have emerged to address various musculoskeletal ailments. We have reviewed the basic science, physiology, and clinical evidence of each of these modalities and discovered that each treatment has its individual place in the management of common orthopaedic pathologies. Bone marrow aspirates are successful in treating early arthritis and cartilage defects. Prolotherapy and platelet-rich plasma have demonstrated good efficacy in treating inflammatory processes and early arthritis. Finally, autologous conditioned serum (Orthokine) represents a promising treatment option for chronic joint arthritis. The clinical evidence supporting these alternative treatment modalities is insufficient and further level 1 evidence is needed before we can begin to employ these techniques in our daily orthopaedic practice.