Objective: To determine the risk factors for meniscal disease and diagnostic accuracy of physical examination in dogs with cranial cruciate ligament (CCL) deficiency. Study Design: Prospective cohort study. Animals: Stifles (n=80) of dogs with CCL deficiency. Methods: Each dog was evaluated preoperatively for factors that may increase the risk of, or aid in the diagnosis of meniscal disease including presence of pain on extension and flexion of the affected stifle, range of motion during flexion and extension, thigh circumference, positive cranial-drawer test, positive tibial compression test, tibial plateau angle, complete tear of the CCL, presence of a meniscal click, and gait analysis. Odds ratios were calculated for each of the factors and a multivariate approach was used to create an ROC curve. Subsequent sensitivity, specificity, and area under the curve was used to determine the diagnostic value of clinical tests. Results: Dogs with pain upon flexion of the stifle were 4.3 times more likely to have medial meniscal disease than those without flexion pain and dogs with a complete CCL tear were 9.6 times more likely to have medial meniscal disease than those with partial tears. A meniscal click increased the likelihood of medial meniscal disease by a factor of 11.3. The diagnostic accuracy using a meniscal click and pain upon stifle flexion was 76%. Conclusion: Combining the presence of a meniscal click and pain during flexion of the stifle provide a more accurate diagnosis of medial meniscal disease in dogs with CCL disease over individual examination variables.