Background: Anterior cruciate ligament (ACL) injuries are common among athletes participating in high-impact sports involving rapid directional changes, pivoting, and cutting movements. Untreated ACL injuries lead to knee instability and can result in significant secondary damage, increasing the risk of early-onset osteoarthritis. Objective: To evaluate the efficacy and clinical outcomes of using the peroneal tendon as an autograft for ACL reconstruction and compare its performance with traditional graft options, such as the patellar and hamstring tendons. Topics of Discussion: Preoperative and postoperative assessments including knee stability and function were discussed. The surgical technique involving careful harvesting and preparation of the peroneal tendon while causing minimal trauma to surrounding tissues. Postoperative rehabilitation protocols to maximize recovery were assessed. Review of Literature: Patients undergoing ACL reconstruction with the peroneal tendon graft demonstrated favourable outcomes, with improvements in knee stability and function comparable to those of traditional graft methods. The incidence of donor-site morbidity was lower, with minimal reports of anterior knee pain or hamstring weakness. Follow-up evaluations showed a high rate of return to pre-injury activity levels and low rates of complications. Conclusion: The peroneal tendon graft is a promising alternative for ACL reconstruction, offering similar biomechanical strength and stability to traditional grafts while reducing donor-site complications. This approach provides an effective option for patients seeking to regain knee function and return to athletic activities.