Sixty-eight patients presenting with acute anterior cruciate ligament (ACL) ruptures were randomized to receive an ACL reconstruction performed acutely (within 8 days of injury) or delayed (6-10 weeks after sustaining an injury). Outcomes of interest included patient-reported outcomes (i.e., Lysholm score, Tegner scores, Visual Analog Scale (VAS) knee function, VAS activity level), knee laxity measurements and tests (i.e., pivot shift test, Lachmann test), International Knee Documentation Committee (IKDC) scores, one-leg hop tests, muscular strength tests (i.e., isokinetic and isometric strength in flexion and extension), range of motion deficit, and the incidence of functional recovery, and treatment failure. Outcomes were assessed up to 24 months post-operation. Significantly favourable VAS knee function scores, VAS activity level scores, isokinetic knee flexion strength at 180 and 240 deg/s, and one-leg hop test scores were observed in the acute reconstruction group compared to the delayed reconstruction group. No significant differences were observed between the 2 treatment arms for all remaining outcomes.