Innovation in ACL injury management has rapidly evolved, driven by improved understanding of knee biomechanics, patient-specific risk factors, and outcomes-based research. The first portion of this presentation, delivered from an orthopaedic sports medicine surgeon’s perspective, will focus on modern concepts in ACL reconstruction, including individualized graft selection, advances in anatomic surgical techniques, and the role of adjunctive procedures such as lateral extra-articular tenodesis (LET). Emphasis will be placed on indications for these innovations, current evidence supporting their use, and how surgical decision-making influences stability, healing biology, and rehabilitation considerations. The second portion of the session will transition to a physical therapy perspective, providing an evidence-based update on contemporary ACL rehabilitation. Topics will include early postoperative management, progressive strengthening and neuromuscular control, criteria-based return-to-running and return-to-sport decision-making, and strategies to reduce secondary ACL injury risk. Together, the presentations highlight the importance of a collaborative surgeon–physical therapist approach, aligning surgical innovation with modern rehabilitation principles to optimize outcomes and safely return athletes to sport.