Objective: To analyze the data of local inflammatory storm after anterior cruciate ligament reconstruction under knee arthroscopy, and to understand the causes and countermeasures. Methods: A retrospective analysis was performed on 135 patients who underwent anterior cruciate ligament reconstruction in the Third Surgical Group of the Department of Orthopedics, the 988th Hospital of the Joint Logistics Support Force from September 2020 to September 2023. The gender, age, injury time, operation time, blood loss, postoperative anticoagulant drug application time, drainage tube application, and other items were collected. The causes of postoperative local inflammatory storm in patients were obtained by binary logistic regression analysis. Results: There were no significant differences in gender, age, injury time, operation time, and blood loss (P > 0.05), but there were significant differences in the placement of drainage tubes and the initiation time of anticoagulant drugs (P < 0.05). Early application of anticoagulants for one day increased the risk of local inflammatory storm after arthroscopic anterior cruciate ligament reconstruction by 0.305 times, and the occurrence of inflammatory reaction without a drainage tube was 5.994 times higher than that with a drainage tube. Conclusions: Premature use of anticoagulant drugs and inadequate drainage may be the main causes of local inflammatory storm in these patients.