Anterior Cruciate Ligament (ACL) reconstruction is a standard procedure for restoring knee stability, utilizing autografts, allografts, or synthetic materials. Each graft type presents unique challenges: autografts risk donor site morbidity, allografts carry potential for disease transmission and delayed incorporation, and synthetic grafts may lead to synovitis or mechanical failure. To optimize outcomes and minimize complications, a comprehensive, individualized approach is essential. This includes careful preoperative patient assessment, precise surgical technique, and tailored postoperative rehabilitation coupled with patient education. The choice of graft must balance risks and benefits according to patient-specific factors and surgical expertise. Continued research into graft biology and surgical methods remains crucial for improving long-term results.