This pilot study presents a technique for three-dimensional and quantitative analysis of meniscus shape, position, and signal intensity and compares results in knees with (n = 20) and without (n = 11) radiographic osteoarthritis. 3-T MR images with 2mm section thickness were acquired using a proton density–weighted, fat-suppressed, coronal, fast spin-echo sequence. Segmentation of the tibial, femoral, and external surface of the medial meniscus and the tibial joint surface was performed. Three-dimensional parameters were computed to describe the shape, position, and signal intensity of the entire meniscus and three subregions (body, anterior, and posterior horn). Key results included a greater size (i.e., volume, surface areas, and thickness), increased medial extrusion (i.e., greater extrusion distance, greater meniscal area uncovered by tibial surface), and elevated signal intensity of the medial meniscus in osteoarthritis than in nonosteoarthritis knees, particularly in the meniscus body. These results need to be confirmed in larger cohorts, preferably under weight-bearing conditions. Magn Reson Med 63:1162–1171, 2010. © 2010 Wiley-Liss, Inc.