Background: Anterior cruciate ligament is the most common knee ligament injury, and they are associated with several long term clinical consequences such as chondral lesions, meniscal tears, and early onset osteoarthritis. The injury can occur with direct contact or without as well. The diagnosis is made with history, special physical examination tests, and using imaging with MRI. Aim of the work: this study was aimed to understand the mechanism behind anterior cruciate ligament injury, its diagnosis, and methods of management. Methodology: we conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE from January 1971 to March 2017. The following search terms were used: Anterior cruciate ligament anatomy, knee ligament injury mechanism, diagnosis of knee ligament injury, management of anterior cruciate ligament injury. Conclusion: Anterior cruciate ligament injury is a very common injury and requires quick diagnosis to control pain, further deterioration, and avoid long term morbidity. Management includes from conservative to surgical repair and reconstruction.