Only recently has the majority of orthopaedic surgeons recognized that anterior cruciate ligament (ACL) insufficiency is one of the most common causes of knee instability and the most common cause due to knee ligament insufficiency. Numerous procedures have been proposed and utilized to compensate for ACL insufficiency, although only a few have survived the test of time.Three years ago, an arthroscopic-assisted patellar-tendon reconstruction technique was developed. This technique essentially eliminates the necessary but substantial surgical trauma to the extensor mechanism and capsular structures of the knee joint that required arthrotomy in delineating and developing the femoral and tibial tunnels. The arthroscopic technique significantly diminishes the intra- and extraarticular adhesions that produce prolonged rehabilitation time in gaining flexion and extension. The results of arthroscopic ACL reconstruction with patellar tendon reveal that the static results are as good as those produced by arthrotomy, with a much lower morbidity rate.