The purposes of this study were to investigate patterns of emotional response to reconstructive surgery of the anterior cruciate ligament (ACL) of the knee following sport injury and to examine the extent to which neuroticism differed across patterns of adjustment. Participants were 73 patients (51% recreational athletes, 46% competitive athletes, 3% nonathletes) who had ACL reconstruction surgery and who had low levels of negative mood before surgery. Participants completed measures of personality and negative mood before surgery and completed daily assessments of negative mood for 6 weeks postsurgery. The negative mood of participants was classified into three patterns for two different time periods. Participants with patterns of resilience outnumbered those with patterns of disturbance. Participants with patterns involving mood disturbance one week after surgery had significantly higher presurgery neuroticism levels. Practitioners should target individuals with high neuroticism before surgery for emotion management interventions to prevent mood disturbance following ACL surgery.