Anterior cruciate ligament (ACL) injuries often result in functional disability, particularly in jumping, cutting, and deceleration activities. Some patients can accommodate to this functional loss, while others require surgical reconstruction of the ligament to provide stability and to protect the meniscus from further injury. Nonoperative management involves an intensive rehabilitation program, patient counseling about high-risk activities, and measures to prevent recurrent injuries. Surgical reconstruction of the ACL involves the technical factors of graft selection, positioning, fixation, and tensioning and the avoidance of stress risers. A supervised and intensive rehabilitation program is necessary to achieve optimal results.