Multiligament knee injuries (MLKIs) present significant challenges due to their complex mechanisms and potential for severe complications, including neurovascular damage. These injuries typically involve damage to two or more of the major knee ligaments, such as the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL), and are often associated with knee dislocations. MLKIs can result from high-energy trauma, such as motor vehicle accidents, or low-energy incidents during sports or even daily activities in obese individuals. Accurate diagnosis and timely management are critical, particularly in preventing complications like vascular injury, which can have catastrophic consequences. This chapter reviews the anatomy, biomechanics, classification, diagnosis, and treatment strategies for MLKIs, with a focus on surgical repair, reconstruction techniques, and rehabilitation protocols.