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The purpose of this study was to identify factors that distinguished between injured athletes who displayed high compared with low levels of rehabilitation adherence following anterior cruciate ligament reconstructive surgery. In order to gain an in-depth understanding of these factors, semistructured qualitative interviews were conducted with six high adherers, six matched low adherers and for each injured athlete, a significant other. Thematic analysis was used to identify the themes that distinguished between high and low adherers. Three themes were generated based on the findings: (a) preparation for postoperative rehabilitation, (b) an active versus passive approach to rehabilitation, and (c) the threat of a poor outcome. Each theme comprised a number of subthemes that further elucidated the participants’ rehabilitation experiences and adherence behaviors. The findings have important implications for medical professionals, sport psychology consultants, coaches, and athletes with a vested interest in expediting recovery following anterior cruciate ligament reconstructive surgery.