The intra-articular migration of a femoral interference screw is a rare complication after anterior cruciate ligament (ACL) reconstruction in the knee. Only a few reports of cases have been published within the last few years and different approaches toward this complication have been described. We report the case of a 23-year-old female patient who was admitted with knee pain after undergoing an ACL reconstruction 4 years previously. After the clinical examination, a knee radiograph in 2 planes revealed a dislocated femoral interference screw lying in the popliteal fossa. During arthroscopy, the interference screw was retrieved through an additional posteromedial portal to avoid an arthrotomy. The causes for intra-articular screw migration are multiple and most cases were reported in the early postoperative period. The arthroscopic removal of a screw is recommended because of the lower morbidity.