Anterior cruciate ligament injuries are among the most common major injuries in sports. If left untreated, anterior cruciate ligament injury can lead to knee instability, premature osteoarthritis, and long-term disability. Not all athletes return to competitive sports. Those who do, experience high risk of sustaining a new injury. Anterior cruciate ligament reconstruction alone is not enough to guarantee a safe return to preinjury activity levels. High-quality goal-based and stepwise rehabilitation that relies on a battery of criteria to allow the player to return to sports is crucial. Time after anterior cruciate ligament reconstruction has been historically used as a solo criterion that is no longer viable. Strength, clinical examination, physical performance-based criteria, and patient-reported outcome measures have also been included as criteria to fulfil before medical clearance to return to sports. Surgical factors, concomitant injuries, and athlete’s intrinsic and extrinsic factors can influence the time to return to play and the clinical outcome. Acknowledging these factors is fundamental to plan and optimize an individualized rehabilitation program. Deciding when the athlete is ready to return to sports is a difficult and complex task. A multifactorial approach, an individualized high-quality rehabilitation, and meeting all objective return to sports criteria are needed to increase the odds of and ensuring a safe return to sports.