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The number of anterior cruciate ligament reconstruction is increasing. Avoiding complications in anterior cruciate ligament reconstruction requires attention to surgical details. Errors during graft harvest, tunnel drilling, graft placement, graft fixation, or the presence of unrecognized pathology can lead to poor outcome. Postoperatively attention must be paid to range of motion, progress with physical therapy, and functional return to activity. Prompt recognition of complications is essential to minimize adverse patient outcomes.