Anterior cruciate ligament (ACL), a structure involved in providing knee stability, is an important restraint for anterior tibial translation and secondary restraint for internal tibial rotation. Injury to ACL, leading to its rupture can cause a lot of problems such as effect on knee stability, cartilage wear and other joint structures. Understanding the anatomy, physiology and the mechanical behavior is important as it helps in the understanding of its function and healing capacity after injury. This review takes a brief look at the anatomy, physiology and mechanical behavior of ACL. The causes of injury and healing process of ACL have also been discussed. This review gives an overview of the surgical treatment options for ACL rupture. These treatment options include methods that have been abandoned like primary repair, methods that are currently in use like the biological grafts and prosthetic grafts that are no longer being used (except LARS which is currently not used widely) due to the complications associated with them. Non-surgical, conservative treatment options for ACL have also been discussed.