AimTo ascertain ACL injury incidence, severity (injury burden) and patterns (contact/non-contact and reinjuries) in a professional male football league in the Middle East over five consecutive seasons.MethodsProspective epidemiological study reporting ACL injuries in professional male soccer players in the Qatar Stars League, with complete matches/training exposure over five seasons (2013–2014 to 2017–2018), corresponding to 2243 player seasons and 729 team months.Results37 complete ACL ruptures occurred in 37 players during 486 951 hours of player exposure. The overall ACL injury rate was 0.076 injuries/1000 hours of exposure (season range 0.045–0.098). Injury incidence during matches and training was 0.41 and 0.04 injuries/1000 hours of exposure, respectively. Match injury incidence was greater than that of training (OR 11.8, 95% CI 6.21 to 23.23, p<0.001). Average injury-related time-loss following ACL injury was 225 days±65 (range 116–360). Overall injury burden was 16.3 days lost/1000 hours of exposure.ConclusionThe overall ACL injury rate in professional male soccer players competing in the Middle East was 0.076 injuries/1000 hours of exposure, match injury incidence was greater than training, while the average ACL time-loss was 225 days.