Tibial eminence fracture, a bony avulsion of the anterior cruciate ligament (ACL) from its insertion on the intercondylar eminence, was first described by Poncet in 1875. Also known as tibial spine fractures, these injuries occur most commonly in skeletally immature patients between the ages of 8 and 14 years. They account for 2% to 5% of knee injuries in the pediatric population and 14% of ACL injuries, and have an incidence of 3 per 100,000 children per year. Although tibial eminence fractures are relatively rare, pediatric knee injuries, in general, are increasing in frequency secondary to increased competitive sports participation, and present a public health problem because of the detrimental effects they can have on the health and well-being of young athletes. Given these concerns, appropriate treatment of tibial minence fractures is paramount to the restoration of knee function, return-to-sports articipation, and overall quality of life.