In rare incidences of combined ruptures of the ACL and patellar tendon, either the patellar tendon ruptures or the associated ACL tear is often initially missed. Even when recognized, there is no established treatment regimen. We report a case of an intercollegiate football player with a combined rupture of the ACL and patellar tendon that was successfully treated by primary augmented repair of the patellar tendon along with ACL reconstruction. Similar to other reported cases, the mechanism of injury involved forceful eccentric contraction of the quadriceps against a fixed foot. Superior displacement of the patella with a palpable defect of the patellar tendon, a positive Lachman test, and an inability to perform terminal knee extension noted during the on-field examination indicated the combined injury. Magnetic resonance and radiographic imaging confirmed conclusions from the on-field examination. The patient also underwent safe early mobilization and weight bearing following surgical repair. © 2007 Arthroscopy Association of North America.