→Arthroscopy of the knee joint produces an initial afferent barrage of pain signals that have the capacity to initiate prolonged changes in the nervous system leading to the amplification and prolongation of postoperative pain. →Preemptive analgesia involves the administration of analgesics prior to painful stimuli to prevent the amplification of postoperative pain. →It is currently recommended that multimodal analgesic regimens be utilized in the management of postoperative pain. →Intra-articular bupivacaine and morphine are effective analgesics for arthroscopic knee surgery. →Intra-articular ketorolac, corticosteroids, and clonidine may also have a role in reducing pain following arthroscopic knee surgery. →Nonsteroidal anti-inflammatory drugs play an important role in the management of postoperative orthopaedic pain, and the newer cyclooxygenase-2-specific nonsteroidal anti-inflammatory drugs may have additional advantages with respect to safety. →Preemptive and multimodal analgesic techniques should be utilized in the management of patients undergoing anterior cruciate reconstruction. Arthroscopy of the knee joint, including reconstruction of the anterior cruciate ligament, is a common procedure that is routinely performed on an outpatient basis. Traditionally, oral analgesics are prescribed for the management of postoperative pain. The routine prescription of oral opioid analgesics administered on an as-needed basis, however, frequently results in inadequate pain relief112. Unrelieved postoperative pain may delay the patient's eligibility for discharge, resulting in a prolonged hospital stay, inability to participate in rehabilitation programs, delayed recovery, poor outcome, and greater use of health-care resources112. At present, several techniques are available to treat pain following arthroscopic knee surgery; these include the use of opioids (providing either peripherally or centrally mediated analgesia), local anesthetics, nonsteroidal anti-inflammatory drugs, corticosteroids, clonidine, and cryotherapy (Fig. 1). In this paper, we will present a review of the current knowledge of the principles of acute pain physiology as well as current techniques for the control of pain associated with …