The aim of this study is a comparative evaluation of the effectiveness of YOLO and RT-DETR family models for the automatic recognition and localization of meniscus tears in knee joint MRI images. The experiments were conducted on a proprietary annotated dataset consisting of 2000 images from 2242 patients from various clinics. Based on key performance metrics, the most effective representatives from each family, YOLOv8-x and RT-DETR-l, were selected. Comparative analysis based on training, validation, and testing results showed that YOLOv8-x delivered more stable and accurate outcomes than RT-DETR-l. The YOLOv8-x model achieved high values across key metrics: accuracy—0.958, recall—0.961; F1-score—0.960; mAP@50—0.975; and mAP@50–95—0.616. These results demonstrate the potential of modern object detection models for clinical application, providing accurate, interpretable, and reproducible diagnosis of meniscal injuries.