Pain and loss of motion of the knee after anterior cruciate ligament reconstruction remain a challenging dilemma. Arthrofibrosis is one of the causes for this problem. Our patient is a young motivated and compliant athlete who underwent anterior cruciate ligament reconstruction who experienced gradual loss of full knee extension within 3 months post operation. Examination showed firm painful swelling over the anteromedial aspect of the knee. Ultrasound suggested of synovial membrane thickening

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... ith irregularity pattern over the localized swelling and tenderness area. Arthroscopic adhesiolysis was performed and finally patient regained full extension and flexion. As conclusion, prevention is still the best form of treatment or otherwise early recognition is needed for early intervention.