Background: There is little known about return to sport and performance after anterior cruciate ligament (ACL) tear in high-level alpine skiers. Purpose: To analyze the parameters that influence the return to sport and performance after an ACL tear in French alpine skiers from 1980 to 2013. Study Design: Descriptive epidemiology study. Methods: The study population included 239 male and 238 female skiers who competed on the national French alpine ski team for at least 1 season between 1980 and 2013 in the speed (downhill and super-G) and technical disciplines (giant slalom and slalom). Two groups were formed: group 1 (G1) included athletes who had sustained an ACL rupture, and group 2 (G2) included athletes who had never sustained an ACL rupture. Three performance indicators were selected: International Ski Federation (FIS) points calculation, FIS ranking, and podium finishes in the World Cup, World Championships, and Olympic Games. Results: The first-decile FIS points and international FIS ranking showed that G1 skiers obtained better performance than did G2 skiers. The mean ± SD career length of G1 skiers (men, 7.9 ± 4.7 years; women, 7.1 ± 4.1 years) was longer than that of G2 skiers (men, 4.5 ± 3.3 years; women, 4.2 ± 3.5 years). In addition, 12.8% (61 of 477) of the skiers achieved at least a podium finish during their careers: 23.0% (34 of 148) in G1 and 8.3% (27 of 329) in G2. The mean age at ACL rupture was 22.6 ± 4.1 years for men and 19.9 ± 3.5 years for women. In G1, 55 podiums were achieved before ACL rupture and 176 after in all competitions. Skiers who improved their performances after ACL rupture were significantly younger (men, 22.2 ± 3.0 years; women, 18.7 ± 2.2 years; P\.0001) at the time of injury than those showing a performance deterioration after ACL rupture (men, 25.3 ± 4.2 years; women, 22.4 ± 4.0 years). All skiers who had ACL tears continued their competitive careers after the injury. Conclusion: The overall results showed that it is possible to return to preinjury or even higher levels of performance after an ACL rupture and that age is the main element that guides postsurgical recovery.