65 patients who underwent an ACL reconstruction with a hamstring tendon for an acute ACL rupture were randomized to receive weekly extracorporeal shockwave therapy (ESWT) between weeks 4 and 6 post-operation (n=37) or no treatment (n=28), in addition to a standard post-operative rehabilitation protocol. The primary outcome of interest was the time to return to pivoting sports. Additional outcomes included the time to return to running activity and pre-injury activity level, pain on a Visual Analog Scale (VAS), the International Knee Documentation Committee (IKDC) score, the Lysholm score, and radiological examination. Follow-up assessment was performed at 3, 6, 9, and 12 months post-operation. Patients who received extracorporeal shockwave therapy reported a shorter time to return to pivoting sports and running activity; 31 patients in the ESWT group attained pre-injury activity levels, vs. 6 in the control group. IKDC, VAS pain, and Lysholm scores were all superior in the ESWT group. Graft maturation, as measured by signal intensity ratio (SIR) was also superior in the ESWT group. The results of this study suggest that performing ESWT post-operation during the rehabilitation phase can significantly improve recovery for patients undergoing a hamstring tendon ACL reconstruction.