Anterior cruciate ligament reconstruction (ACLR), despite its effectiveness in restoring knee stability and function, can have associated morbidity. The most frequent complications are technical errors, which have been described during graft harvesting, tunnel placement or graft fixation. The most serious complications are neurovascular injuries, arthrofibrosis and infections. Recently, several high-quality studies have been published to help surgeons improve their performance in this surgery. Each stage of the surgical process carries potential complications, even when safe techniques are followed. When complications arise, it is crucial to promptly recognize them and adhere to established guidelines to effectively correct, minimize, or resolve the issues. In this review article, we have attempted to summarise the best available evidence addressing ACLR complications, following our primary goal of improving the outcomes for patients who suffer an ACL injury.