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Isolated injuries of the posterior cruciate ligament (PCL) are rare in comparison to other ligamentous knee injuries, resulting in a lack of evidence-based literature regarding their treatment. Although consensus exists regarding the nonoperative management of asymptomatic grade I injuries, the treatment of high-grade symptomatic PCL insufficiency remains a matter of debate. A variety of reconstructive procedures have been advocated on the basis of biomechanical data, however, the clinical benefit of these anatomic reconstructive techniques have yet to be conclusively proven in randomized trials. This article attempts to provide the treating physician with a concise overview of the etiology and diagnosis of isolated PCL injuries as well as an objective review of contemporary surgical treatment options and outcomes as reported in the current literature.