The journey back to sport after a knee injury is fraught with challenges, not least of which are psychological. This chapter delves into the essential role of psychological readiness in the return to sport after knee injuries, emphasizing that psychological factors are as crucial for a successful return to sport. Psychological readiness involves an athlete’s cognitive, emotional, and behavioral preparedness, impacting reinjury rates and long-term participation. The Strategic Assessment of Risk and Risk Tolerance framework provides a structured approach for integrating psychological and physical factors, highlighting the role of psychological readiness in return to sport decision-making. Clinicians use a combination of generic and knee-specific scales to evaluate psychological readiness, allowing for a thorough understanding of an athlete’s overall mental state and addressing the unique psychological challenges associated with knee injuries, thereby facilitating a more tailored and effective rehabilitation process. Practical strategies for clinicians include early psychological assessment, tailored interventions, and ongoing monitoring post-return to sport. The chapter advocates for a holistic, interdisciplinary approach to support athletes in overcoming psychological barriers and achieving a successful return to sport.