Anterior cruciate ligament (ACL) reconstruction (ACLR) is one of the most common surgical procedures. Although ACLR is a successful operation, the increasing frequency of ACLR is also leading to an increased number of revision procedures. Etiologies for graft rupture are varied and can include numerous factors: technical errors, repeat trauma, misdiagnosed/untreated associated peripheral laxities or meniscus injuries, biological failure and low-grade infection Preoperative evaluation before revision ACLR should include a detailed history and physical exam, as well as radiographs and magnetic resonance imaging to evaluate graft integrity and for concomitant injuries, as well as computed tomography to measure for bone tunnel osteolysis. Revision ACLR is a challenging procedure as the surgeon often needs to address one or more underlying causes of primary ACLR failure. Surgical treatment for revision ACLR includes a 1-stage or 2-stage procedure with possible bone grafting and repair of associated injuries. Repositioning of the femoral and/or tibial tunnels, treatment of concomitant Medial Collateral Ligament (MCL), posterolateral corner (PLC), and lateral collateral ligament (LCL) injuries or meniscus pathology, and osteotomy to treat valgus or varus malalignment or increased tibial slope may be necessary in the setting of revision ACLR. There is also evidence that the results of revision surgery are generally inferior compared with those of primary surgery.