The most frequent type of ligament injury is an anterior cruciate ligament (ACL). The mechanisms of an ACL injury are classified as direct contact, indirect contact, and non-contact. Physical examination for the assessment of the ACL is commonly used in routine care in the evaluation of the knee and is part of the diagnostic process. Due to the high degree of variability in their presentation and outcomes, treatment must be tailored according to factors such as patient demographics, the severity of the damage, and long-term improvement profile. When it comes to ACL injuries, low-quality data have been produced that reveals no difference in patient-reported knee function results between surgical ACL restoration and conservative therapy. However, these results must be evaluated in the perspective of the fact that many individuals with an ACL rupture remained symptomatic after rehabilitation and eventually underwent ACL reconstruction surgery. This article has reviewed the risk factors and the mechanisms that commonly lead to ACL injuries. This article has also discussed the clinical significance of conservative and surgical management and has highlighted the implications of both approaches.