Significant advances in arthroscopic techniques have led to wide-spread performance of arthroscopically assisted ACL reconstruction. Properly performed reconstruction has proved to be successful clinically. The surgeon who undertakes ACL reconstruction must be familiar with techniques for both autograft hamstring augmentation and bone-patellar tendon-bone ACL reconstruction for the ACL-deficient knee. The arthroscopic techniques discussed in this article will allow successful treatment of most acute and chronic ACL injuries. Arthroscopic ACL reconstruction is a highly demanding procedure, with the possible risk of significant knee disability if the ACL graft is placed improperly. Proper patient selection, surgical technique, and postoperative rehabilitation remain the foundations for successful ACL reconstruction.