Anterior cruciate ligament (ACL) injury is a common and debilitating condition, particularly among athletes. This comprehensive review examines the etiology, diagnosis, treatment strategies, and outcomes associated with ACL injury. Anatomical factors, such as the orientation of the femoral and tibial tunnels, inuence ACL injury risk. Biomechanical studies have highlighted the role of dynamic knee stability in ACL injury mechanisms. Diagnosis involves a combination of physical examination maneuvers and imaging modalities. Treatment options range from conservative management to surgical reconstruction using autografts or allografts. Factors such as age, activity level, and associated injuries inuence treatment decisions and outcomes. Rehabilitation plays a crucial role in optimizing outcomes and reducing the risk of reinjury. Future research should focus on rening prevention strategies, improving surgical techniques, and enhancing rehabilitation protocols to optimize outcomes for individuals with ACL injury.