Cranial cruciate ligament rupture is one of the most important diseases in canine orthopedics. Despite the frequent occurrence of the disease and the extensive literature available, there is still controversy about the best treatment method. The aim of this review article is to present a new, more specific approach to treatment selection in dogs with cranial cruciate ligament rupture. Patients are divided into different groups and particular treatment methods are then recommended according to group membership. In order to develop the treatment recommendations, the patient groups were initially defined based on criteria that are important for treatment selection, such as type of cranial cruciate ligament rupture, chronicity, degree of instability, size and weight of the patient, stage of osteoarthritis, the presence of bone deformities, concurrent medial patellar luxation or rotational instability. A detailed literature search was conducted through MEDLINE/PUBMED; CAB Abstracts, Google -Scholar and in conference proceedings abstracts from 1990-2019. Based on the available literature, treatment recommendations were developed for each patient group. These patient group-specific recommendations based on best available evidence are intended to simplify the decision-making process for treatment selection in dogs with cranial cruciate ligament disease.