Thirty patients who underwent unilateral anterior cruciate ligament (ACL) reconstruction were randomized 1:1 to conventional rehabilitation or immersive virtual reality (VR) assisted rehabilitation plus conventional therapy. VR sessions began at 3 months, delivered once every 2 weeks for 30 minutes each, while baseline and 6-month outcomes assessed limb loading symmetry, dynamic balance (SEBT), range of motion, hop tests, pain (NRS), and international knee documentation committee (IKDC) scores. Overall, the study revealed no significant differences between groups for limb loading, balance, range of motion, or cumulative hop test performance. However, VR patients experienced significantly greater improvements in pain reduction (p=0.012) and IKDC subjective knee scores (p=0.024) compared with conventional rehabilitation alone. VR also produced a superior single-leg hop LSI (p=0.002). No adverse events occurred. These findings suggest immersive VR may enhance perceived knee function and pain control without changing objective functional outcomes.