Anterior cruciate ligament (ACL) injury is one of the most frequently encountered cases of ortho-pedists interested in sports surgery. Conditions such as the rapid advancement of technology, the expansion of research in basic sciences, the increase in the desire to preserve ACL during surgery, the popularity of biological agents, and the increased interest in preventing ACL injury are shaping the current literature. The purpose of all these studies in the literature is to return patients safely to their pre-injury status. In this review; by reviewing the current literature, innovations and controversial issues in the treatment of ACL injury were reviewed.