Many graft choices are available for the reconstruction of the posterior cruciate ligament (PCL)-deficient knee. These choices range from multiple autograft and allograft sources. Preoperative planning must take into account the viability of knee autografts and the availability of allografts. The nature of the PCL injury must also be taken into account, such as whether only the PCL is deficient or the PCL lesion is part of a complex multiple ligament-injured knee. Our institution has begun to use the central quadriceps tendon bone autograph for multiple types of PCL reconstructions. This paper discusses the surgical techniques used to harvest and secure a double-bundle central quadriceps tendon bone autograph for PCL reconstructions using both open and arthroscopic approaches.