Anterior cruciate ligament ruptures continue to occur in increasing numbers. These injuries and their treatment create significant social and economic problems for patients, their physicians, and for society. By critically evaluating the trade-off between the costs and benefits of various treatment options, one can define a cost-effective approach to the management of this problem. Limited available data suggest that anterior cruciate ligament reconstruction is a highly cost-effective method of treatment for active young adults. The cost per additional quality-adjusted life year provided by surgery compares favorably with figures associated with other highly utilized health care interventions. Such data may prove invaluable within the context of health care reform.