Anterior cruciate ligament (ACL) tear is a common knee injury, often resulting in knee instability. Anterior cruciate ligament reconstruction surgery (ACLR) is widely accepted for treating a torn ACL to reestablish stability and for preventing meniscal and cartilage damage. The incidence of ACL injuries is increasing worldwide, and consequently, the number of ACLR. Since not all cases have good or excellent outcomes, our main concern is to achieve the objectives of this procedure, which are restitution of knee stability and facilitate a safe return to sports while preserving the knee. The aim of this chapter is to present a synthesized analysis of the perioperative concerns in ACLR, addressing the importance of identifying the risk factors for potential complications in every single case.