Parallel to the increasing number of primary anterior cruciate ligament reconstructions (ACLR), the requirement for revision anterior cruciate ligament (ACL) surgery is also steadily rising. Revision of a failed ACLR is a highly complex surgical procedure due to tunnel osteolysis, previous hardware, and limited donor tissue sources. Selecting the appropriate graft stands out as one of the most critical and modifiable steps to achieve success in revision surgery. To this end, the patient’s primary surgical history, tunnel anatomy, concomitant intraarticular pathologies, and activity expectations must be thoroughly analyzed, and a meticulous preoperative planning should be performed. In clinical practice, conventional extensor mechanism autografts (bone patellar tendon bone and quadriceps tendon), hamstring tendons, and non-knee alternatives such as the peroneus longus tendon remain the cornerstone options alongside allografts, xenografts, and tissue-engineered products. While large-scale registry data demonstrate the superiority of autografts regarding long-term survivorship, allografts, xenografts, and synthetic structures are considered with more selective indications due to their specific limitations. Although the literature reports that revision ACL surgery may not yield functional success rates as high as primary reconstructions, highly satisfactory clinical outcomes can be achieved through a patient-specific, personalized graft selection that accounts for biomechanical properties and histological integration kinetics.