Anterior cruciate ligament (ACL) rupture is a common injury, and ACL reconstruction has reached a very mature level over the past decades. Techniques including single-bundle and double-bundle reconstruction can achieve good clinical results. However, more attention has been paid to ACL combined with anterolateral structure (ALS) reconstruction for better control of rotational laxity and the pivot shift phenomenon. This paper reviews the studies of anatomy and isometry of ALS, and the surgical indications and techniques for combined ACL and ALS reconstruction.