OBJECTIVE Articular cartilage injuries commonly occur in conjunction with anterior cruciate ligament (ACL) injury. The exact incidence of this combined injury pattern, as well as the optimal treatment for it, has not been well studied in the literature. The purpose of this study was to systematically review the literature regarding the incidence of concomitant articular cartilage and ACL injury and the results of combined surgical treatment of these injuries. METHODS We performed a systematic review of studies investigating the incidence of articular cartilage injury in conjunction with ACL injury and the results of combined surgical treatment for these injuries. RESULTS On the basis of 5 studies in the literature, the incidence of severe articular cartilage injury in acute ACL tears is between 16% and 46%. On the basis of 3 studies on combined osteochondral autografts and ACL reconstruction and 2 studies on combined autologous chondrocyte implantation and ACL reconstruction, patients can have reasonable short-term outcomes after combined surgery. CONCLUSIONS Articular cartilage injury is often encountered at the time of ACL reconstruction, and combined surgery can result in reasonable outcomes. Additional studies are needed to better define both the incidence of combined injury and the outcome, particularly in the long term, after these procedures.