Anterior cruciate ligament (ACL) injuries are among the most common and devastating injuries sustained in athletes and often result in significant time missed from competitive play. There are many risk factors for sustaining ACL injuries, including patient-specific factors such as age, gender, type of sport, and anatomic knee morphology, as well as environmental risk factors such as playing field surface and shoe wear. A thorough history and physical examination, combined with evaluation of imaging findings, will confirm the diagnosis. Management options include operative and nonoperative management. Surgical management most commonly involves anterior cruciate ligament reconstruction, and specific considerations, including graft selection, should be discussed. Associated procedures, including meniscus repair and lateral extra-articular tenodesis (LET) should also be considered based upon patient-specific findings. Complications, including medical types such as deep vein thrombosis (DVT), and surgical complications, such as arthrofibrosis, retear, and donor-site morbidity, occur and should be managed in accordance with the acuity of the issue and ultimate patient activity goals.