Anterior cruciate ligament (ACL) tears constitute the most common ligamentous injury in the knee. Surgical options for the restoration of the mechanical function of the ACL include primary repair, or ACL graft reconstruction. Primary repair is useful for cases of tibial avulsion of the ACL. MRI is the modality of choice for the evaluation of graft integrity. Potential complications are demonstrated optimally with MRI. A clear knowledge of the imaging appearance of the normal ACL graft is essential for the accurate assessment of possible complications after ACL graft reconstruction.