Background: because of the high incidence of anterior cruciate ligament (ACL) injuries among the population, these have been the subject of many recent studies. It is the most commonly reconstructed ligament in the knee. Its clinical evaluation is difficult. MRI is reliably and accurately used to assess ACL-R complications. Objective: this work is an attempt to spot light the diagnostic value of MR imaging in assessment of anterior cruciate ligament reconstruction graft for distinction of its various common complications. Patients and methods: this prospective study was conducted on 50 patients with postoperative knee reconstruction of ACL. The study was done between the duration of (April 2014 to February 2019) in an MRI unit of a private radiology center. All cases were referred from the orthopedic department of New Cairo Hospital. Results: according to our results, 33 (66%) cases showed osteoarthritic changes, suggesting that the development of osteoarthritis is one of the common complications of ACL reconstruction, however it can't be considered the commonest complication as it can be explained by the associated risk factor as meniscal or chondral lesion. Thus osteoarthritic changes can be considered is one of the most common associated findings of ACL reconstruction and ACL reconstruction can be a risk factor for development of osteoarthritis. Conclusion: MRI of the knee is indispensable and the preferred modality in evaluating the integrity of the ACL graft and can be reliably and accurately used in diagnosing complications associated with ACL reconstruction.