Posterior cruciate ligament (PCL) injuries are less frequent in the athletic population than injuries to theanterior cruciate ligament. Some reports indicate a ratio of 13 to 1 in these injuries. Recent reports on traumatic/nonathletic injuries detects a high percentage of primary PCL injuries that may go undetected or unattended because of severity of associated traumatic conditions. Arthroscopic technique of reconstructing the PCL regardless of substitute used seems to be superior to standard open technique and offers less morbidity, better visualization, and more precise placement of the graft. However, because of the closeness of the delicate neurovascular structure in the popliteal area meticulous attention to detail and precision technique is mandatory. This technique is not for the casual arthroscopist, a high level of arthroscopic skills are necessary to perform the procedure safely and accurately.