This chapter presents a case scenario of an 18‐year‐old varsity football player who presents to clinic complaining of right knee pain and instability after sustaining an injury in practice one month ago. The choice of graft can have important implications for outcome and function after anterior cruciate ligament (ACL) reconstruction. ACL ruptures are devastating injuries and can lead to recurrent instability, degenerative changes, and chronic pain. Multiple randomized controlled trials have compared the efficacy of various autografts compared to both irradiated and nonirradiated allografts in different populations. Some experts favor bone patellar tendon bone (BPTB) because of faster graft incorporation, potential for lower risk of graft rupture, and postoperative hamstring weakness. BPTB is generally considered to have higher donor site morbidity. The chapter provides recommendations for implementing evidence‐based practice in the clinical setting.