Purpose of Review <p>Outcomes after anterior cruciate ligament reconstruction (ACLR) are generally favorable, yet the timing and extent of return to sport vary widely and are influenced by numerous factors. This review examines the principal pre-operative, intra-operative, and post-operative considerations that influence return to sport following ACLR.</p> Recent Findings <p>Successful return to sport depends on many crucial elements during the pre-operative, intra-operative, and post-operative periods. Recent developments for adjunctive rehabilitation modalities—such as blood flow restriction, hyperbaric oxygen therapy, cryotherapy, and photo-biomodulation—may further enhance recovery for some patients. Additionally, psychological readiness has emerged and continues to grow as a key predictor of both the timing and success of return to sport.</p> Summary <p>A criteria-based strategy that integrates physical performance, sport-specific skills, and psychological preparedness offers the most reliable framework for tailoring rehabilitation and maximizing retorn-to-sport outcomes following ACL reconstruction.</p>