There is a relative lack of research and literature investigating injuries to the posterior cruciate ligament (PCL), despite the fact that it is an important knee stabilizer. The PCL is injured less frequently than other knee ligaments, and the mechanism is usually a direct blow to the anterior aspect of a flexed knee. Clinical examination of a PCL-deficient knee may reveal a positive posterior drawer, quadriceps active test, or Godfrey test. Chronic PCL insufficiency may result in patellofemoral and medial compartment degenerative arthritis. Controversy exists over the treatment of PCL injuries, with the exception of surgical treatment of avulsion fractures. Many believe that isolated PCL injuries of any grade may be treated nonoperatively with an excellent outcome. However, PCL reconstruction is recommended for patients with grade III PCL injuries who remain symptomatic despite adequate physical therapy or if the PCL deficiency is part of a multiple-ligament knee injury.