The management of anterior cruciate ligament (ACL) ruptures is carried out differently in prevention, treatment and rehabilitation for athletes than for non-athletes. However, different approaches to managing ACL ruptures are also discussed in different sports. This narrative review includes first time the current situation of ACL management in football by experiences from the practical routine as well as from scientific reports. No other sport shows such high number of literature reports and sufficient scientific evidence in the management of ACL ruptures like football and this article provides a football specific overview in prevention, treatment and return to sports strategies. These scientific reports underline the surgical treatment of ACL ruptures in football player and show a high sustainability and return to sports rate. However, reports from football show that despite good knowledge, the implementation of sustainable prevention and rehabilitation is difficult and needs improvement.