Accurate deployment of the femoral button on the lateral aspect of the lateral femoral condyle when using a suspensory fixation device for anterior cruciate ligament reconstruction is ideal. Direct visualization would be the most appropriate method of visualization in the lateral gutter. A previously described technique is performed with the knee in flexion. In this position, maneuverability of the arthroscope in the lateral gutter may be difficult in small knees because of tight lateral structures. We describe a simple technique in which visualization is performed with the knee in extension, which is especially useful in small knees.