With the increasing importance of sport activities and with better diagnostic modalities, the recognized incidence of anterior cruciate ligament (ACL) ruptures has risen in the past years, increasing numbers of ACL reconstructions have been registered in Europe and the USA.Long-term follow-up studies have shown that ACL rupture is associated with the development of chondral injuries, meniscal tears, Degeneration of the articular cartilage, and eventually posttraumatic arthritis of the medial compartment.Comprehensive knowledge of the anatomy of the ACL can provide the orthopedic surgeon with a clue for the idealized reconstruction of this most complex structure.One of the controversial topics in ACL reconstruction is the choice of a graft and its fixation.