Following a severe knee sprain during which the anterior cruciate ligament has been torn, the patient and his doctor are facing the choice between a conservative treatment or a surgical approach. Reviewing the international literature allows us to build a pertinent opinion. If the conservative treatment is selected, one must be aware that the proportion of good results does not exceed 50%. This is why, this treatment is only recommended for little demanding and non-sports active persons. In various surgical options, the autologous anterior cruciate ligament reconstruction, using a graft of patellar or hamstrings tendons gives good, reliable and reproducible results.