Anterior cruciate ligament (ACL) tibial avulsion predominantly affects children and young adults, often resulting from hyperextension injuries similar to those incurred while riding a bicycle. This condition severely restricts knee range of motion, causes swelling, prevents weight-bearing, and results in continuous pain. Acute swelling complicates clinical examination. Treatment methods for bony ACL avulsion from the tibial side range from conservative management to various surgical procedures, which often require advanced skills, significant time, and resources. In this chapter, we present a technique for treating Meyers-McKeever type II, III, and IV bony tibial ACL avulsions. This method employs standard anterolateral and anteromedial portals, along with an additional transpatellar portal. The avulsed fragments and ACL are secured using FiberWires and fixed to the intra-articular portion of the proximal tibia. This all-inside technique is straightforward and can be easily mastered, even by beginners.