One hundred fifty patients undergoing arthroscopic ACL reconstruction (ACLR) were randomized into three groups: the Anteromedial Portal technique (AMP) (n=50), the Far Anteromedial Portal technique (FAMP) (n=50), and the Outside-In drilling technique (OI) (n=50). The primary outcome was the accuracy of femoral tunnel placement, classified using the Magnussen method. Secondary outcomes included tunnel length, orientation (Basdekis method), and entry point position (Brand Hertel quadrant method). Outcomes were assessed using postoperative 3D CT. Overall, the results showed that all three techniques achieved satisfactory femoral tunnel placement in 80% of cases. However, FAMP and OI demonstrated superior accuracy in achieving the ideal tunnel location. The OI technique consistently yielded longer tunnels, which may help prevent lateral blowout when using suspensory fixation. These findings suggest that the OI and FAMP techniques provide better anatomical accuracy in femoral tunnel placement compared to AMP.