Recently, more inclination toward reconstructive rather than non-operative management of anterior cruciate ligament (ACL) injuries in the skeletally immature has been observed in order to lower the risks of further meniscal and chondral damage. This has led to more failures and the need for more revisions. Age, time to return to sports, graft type, size and diameter along with the surgical technique in ACL reconstruction are the commonest causes of failures. ACL revisions in the skeletally immature are challenging. In the current chapter, we discuss risks, causes and analysis of failures, concerns and how to avoid complications in revision, our recommendations in revision, and the return to sports after revision.